scholarly journals Respiratory pattern, thoracoabdominal motion and ventilation in chronic airway obstruction

2016 ◽  
Vol 67 (4) ◽  
Author(s):  
M. Fernandes ◽  
A. Cukier ◽  
N. Ambrosino ◽  
J.J. Leite ◽  
M.I. Zanetti Feltrim
Keyword(s):  
Breathing Pattern ◽  
Minute Ventilation ◽  
Respiratory Pattern ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Lower Oxygen ◽  
Shallow Breathing ◽  
Diaphragmatic Movement ◽  
Severe Copd

Background. Patients with chronic obstructive pulmonary disease (COPD) present abnormal respiratory mechanics, but its relation to ventilation variables at rest is not fully understood. Methods. We evaluated breathing pattern, thoracoabdominal motion, and ventilation in moderate and severe COPD patients by means of respiratory inductive plethysmograph and analysis of respiratory metabolism in semirecumbent position at rest. Diaphragmatic movement was measured using radiographs. Results. COPD patients showed an increase in mean inspiratory flow, minute ventilation, dead space ventilation, oxygen and carbon dioxide ventilatory equivalents and reduction of respiratory times and pulse oxymetry. These findings were more pronounced in severe COPD. Changes in ventilatory efficiency were correlated with decreased respiratory times, reduced diaphragmatic movement, and lower oxygen uptake. Conclusions. Rapid shallow breathing and reduced diaphragmatic movement have led to ventilatory inefficiency without changes in thoracoabdominal motion.

Oxygen cost of increasing tidal volume and diaphragm flattening in obstructive pulmonary disease

1993 ◽  
Vol 74 (6) ◽  
pp. 2750-2756 ◽  
Author(s):  
W. D. Pitcher ◽  
H. S. Cunningham
Keyword(s):  
Tidal Volume ◽  
Pulmonary Disease ◽  
Breathing Pattern ◽  
Minute Ventilation ◽  
Respiratory Muscles ◽  
Normal Subjects ◽  
Chronic Obstructive ◽  
Oxygen Cost ◽  
Obstructive Pulmonary Disease ◽  
Shallow Breathing

Hypercapnia is associated with a shallow breathing pattern in patients with severe chronic obstructive pulmonary disease (COPD). We sought to determine the oxygen cost of increasing tidal volume and to relate this to hypercapnia [arterial PCO2 (PaCO2) > or = 45 Torr] and diaphragm flattening. We studied 3 normal subjects and 12 patients with stable but comparably severe COPD (forced expired volume in 1 s 1.01 +/- 0.09 liters) who had baseline PaCO2 ranging from 36 to 56 Torr. Oxygen consumption was measured during the subject's native breathing pattern and then while tidal volume was increased by 20%; minute ventilation was held constant by proportionately slowing frequency. There was a significant oxygen cost of increasing tidal volume for hypercapnic patients (235 +/- 23 to 260 +/- 25 ml O2/min; P = 0.002); no significant oxygen cost was observed in normal or eucapnic patients. This oxygen cost was positively correlated to baseline PaCO2 (r2 = 0.88, P < 0.001) and degree of diaphragm flattening assessed from chest radiographs (r2 = 0.74, P < 0.05). Although others have shown that force generation is preserved during chronic hyperinflation (G. A. Farkas and C. Roussos. J. Appl. Physiol. 54: 1635–1640, 1983; T. Similowski et al. N. Engl. J. Med. 325: 917–923, 1991), we conclude that diaphragm flattening produces mechanical inefficiency that may contribute to limiting the effective operating range of the respiratory muscles during tidal breathing.

scholarly journals Prevalence of obstructive sleep apnea among patients with chronic obstructive pulmonary disease

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Osama Ibrahim Mohammad ◽  
Ahmed Gouda Elgazzar ◽  
Shymaa Mohammad Mahfouz ◽  
Marwa Elsayed Elnaggar
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obese Patients ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Obstructive Sleep ◽  
Severe Copd

Abstract Background The conjunction of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is known as overlap syndrome (OS). The coexistence of these diseases has cardiovascular morbidity and mortality. The aim of this study is to assess the prevalence of OSA in COPD patients. One hundred COPD patients (obese and non-obese) performed sleep questionnaires and polysomnograms. Results OSA prevalence in COPD was 50% and it increases with increasing disease severity (P < 0.001). The highest prevalence of OSA was found in obese patients with severe COPD; 90.5% of these patients have OSA. In the OSA group, obese patients were found to have significantly higher STOP-Bang Questionnaire (SBQ), Epworth Sleep Scale (ESS), modified medical research council (mMRC) dyspnea scale, apnea-hypopnea index (AHI), respiratory disturbance index (RDI), and oxygen desaturation index (ODI). Both obese and non-obese COPD patients showed significant positive correlations between AHI and smoking index (SI), SBQ, ESS, mMRC, ODI, and neck circumference (NC). Conclusions From this study, it can be concluded that moderate and severe COPD patients had a higher diagnosis of sleep-disordered breathing. Also, obese-COPD patients are more susceptible to develop OSA. Trial registration Name of the registry: Benha University Protocol Record Benha U123, Obstructive Sleep Apnea Prevalence in Patients With Chronic Obstructive Pulmonary Diseases. Trial registration number: NCT04903639. Date of registry: 5/22/2021 (retrospective study).

scholarly journals Decreased plasma epidermal growth factor (EGF) levels in patients with severe chronic obstructive pulmonary disease

Pneumologia ◽  
2019 ◽  
Vol 68 (1) ◽  
pp. 21-26
Author(s):  
Retno AS Soemarwoto ◽  
Andika Chandra Putra ◽  
Syazili Mustofa ◽  
◽  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Pulmonary Disease ◽  
Plasma Levels ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Epidermal Growth ◽  
Severe Copd

Abstract Background Chronic mucus hypersecretion is a common feature in chronic obstructive pulmonary disease (COPD) and is associated with epidermal growth factor (EGF) activity. Aberrant EGF and its receptor signalling can cause airway hyperproliferation, increase in mucous cell differentiation and mucus hyperproduction. Furthermore, it can also promote subepithelial fibrosis and excessive collagen deposition in COPD. The objective of this research was to investigate the plasma levels of EGF in smokers with COPD in comparison with clinically healthy smokers. In addition, the relationship between the plasma levels of EGF and clinical features was investigated. Methods A cross-sectional study included 82 clinically stable male patients with mild-to-very severe COPD (mean age: 64.5±8.6 years), and the control group consisted of 86 healthy male smokers (mean age: 61.6±9.5 years). To define COPD, we performed spirometry and classified COPD using Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification. We analyzed the levels of EGF by enzyme-linked immunosorbent assay in plasma. Results The mean serum levels of EGF were significantly lower in smokers with COPD than those in controls (69.30 and 83.82 pg/mL, respectively, p = 0.046). The plasma levels of EGF were significantly different (p = 0.004) between mild COPD and moderate-to-very severe COPD. There were no significant differences between the levels of EGF in plasma of spontaneous sputum producers (COPD patients) vs. nonsputum producers (p = 0.101) and between nonexacerbated COPD and exacerbated COPD patients(p = 0.138). Conclusions There is a significant difference in the plasma levels of EGF in male smokers with COPD as compared with male healthy smokers. Our findings suggest that the plasma levels of EGF may contribute to the pathogenesis of COPD.

scholarly journals Relationship of the Content of Systemic and Endobronchial Soluble Molecules of CD25, CD38, CD8, and HLA-I-CD8 and Lung Function Parameters in COPD Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Nailya Kubysheva ◽  
Larisa Postnikova ◽  
Svetlana Soodaeva ◽  
Viкtor Novikov ◽  
Tatyana Eliseeva ◽  
...  
Keyword(s):  
Lung Function ◽  
Blood Serum ◽  
Exhaled Breath Condensate ◽  
Diagnostic Methods ◽  
Stable Phase ◽  
Chronic Obstructive ◽  
Exhaled Breath ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Severe Copd

The definition of new markers of local and systemic inflammation of chronic obstructive pulmonary disease (COPD) is one of the priority directions in the study of pathogenesis and diagnostic methods improvement for this disease. We investigated 91 patients with COPD and 21 healthy nonsmokers. The levels of soluble CD25, CD38, CD8, and HLA-I-CD8 molecules in the blood serum and exhaled breath condensate (EBC) in moderate-to-severe COPD patients during exacerbation and stable phase were studied. An unidirectional change in the content of sCD25, sCD38, and sCD8 molecules with increasing severity of COPD was detected. The correlations between the parameters of lung function and sCD8, sCD25, and sHLA-I-CD8 levels in the blood serum and EBC were discovered in patients with severe COPD. The findings suggest a pathogenetic role of the investigated soluble molecules of the COPD development and allow considering the content of sCD8, sCD25, and sHLA-I-CD8 molecules as additional novel systemic and endobronchial markers of the progression of chronic inflammation of this disease.

scholarly journals Study of Factors Associated with Sarcopenia in COPD Patients

2021 ◽  
Vol 33 (1) ◽  
pp. 50-53
Author(s):  
Saleh Ahmed
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Bioelectrical Impedance ◽  
Chronic Obstructive ◽  
College Hospital ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Factors Associated ◽  
Copd Patients ◽  
Severe Copd

Introduction: Sarcopenia is frequently associated with chronic diseases such as chronic obstructive pulmonary disease (COPD). Sarcopenia can be classified as physical frailty where frailty is associated with adverse health outcomes. Sarcopenia was found to be associated with worsening lung function in male COPD patient. Objective was to find out the factors associated with sarcopenia in COPD patients. Materials & Methods: This was cross-sectional observational study was carried out Different Privet Medical in Chandpur and Chandpur Medical College Hospital, Chandpur. Patients diagnosed with COPD according to Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) guidelines were included in this study. Exclusion criteria were unstable cardiac disease, an exacerbation within the preceding 4 weeks, predominant neurological limitation to walking (eg, significant hemiplegia) or contraindication to bioelectrical impedance analysis (BIA) including an implanted pacemaker or defibrillator. All participants gave written informed consent. EWGSOP criteria were applied to outpatients with stable COPD. Results: In uniavariate analysis, age, moderate COPD, severe COPD, obesity, non-elective admission over the past 12 months, MMRC scale and MAP were significantly associated with sarcopenia. In multivariate analysis, age, moderate COPD, severe COPD, obesity and MMRC scale were significantly associated with sarcopenia. Conclusion: Prevalence of sarcopenia was 26%. Independent factors associated with sarcopenia Age (>70 years) years (adjusted odds ratio (AOR) 4.387. Sarcopenia affects about one-quarter of COPD patients. Age, severity of COPD, MMRC scale, and BMI status were the factors associated with sarcopenia. Medicine Today 2021 Vol.33(1): 50-53

Intercept of minute ventilation vs. carbon dioxide output relationship in chronic obstructive pulmonary disease: utility as an index of ventilatory inefficiency

2020 ◽  
Author(s):  
Haoyan Wang ◽  
Fang Lin ◽  
Shan Nie ◽  
Ranran Zhao ◽  
Min Cao ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Minute Ventilation ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Lung Hyperinflation ◽  
Carbon Dioxide Output ◽  
Copd Patients

Abstract Background: Ventilatory inefficiency is known to be a contributor to exercise intolerance in chronic obstructive pulmonary disease (COPD). The intercept of the minute ventilation (V̇E) vs. carbon dioxide output (V̇CO2) plot is a key ventilator inefficiency parameter. However, its relationships with lung hyperinflation (LH) and airflow limitation are not known. This study aimed to evaluate the correlations between the V̇E/V̇CO2 intercept and LH in COPD to determine its utility as an index of functional impairment.Methods: We conducted a retrospective analysis of data from 53 COPD patients and 14 healthy controls performed incremental cardiopulmonary exercise tests and resting pulmonary function. Ventilatory inefficiency was represented by parameters reflecting the V̇E/V̇CO2 nadir and slope (linear region), and intercept of the V̇E/V̇CO2 plot. Their correlations with measures of LH and airflow limitation were evaluated.Results: Compared to the control, the slope (30.58±3.62) and intercept (4.85±1.11) higher in COPDstages1-2, leading to a higher nadir (31.47±4.47) (p<0.05). Despite an even higher intercept in COPDstages3-4 (7.16±1.41), the slope diminished with disease progression (from 30.58±3.62 in COPDstages1-2 to 28.36±4.58 in COPDstages3-4). Compared to the V̇E/V̇CO2 nadir and V̇E/V̇CO2 slope, the intercept was better correlated with peak V̇E/maximal voluntary ventilation (MVV) (r=0.489, p<0.001) and peak V̇O2/watt (r=0.354, p=0.003). The intercept was also significantly correlated with RV/TLC (r=0.588, p<0.001), IC/TLC (r=-0.574, p<0.001), peak VT/TLC (r=-0.585, p<0.001); and airflow limitation forced expiratory volume in 1s (FEV1) % predicted (r=-0.606, p<0.001) and FEV1/forced vital capacity (FVC) (r=-0.629, p<0.001).Conclusion: V̇E/V̇CO2intercept was consistently better correlated with worsening static and dynamic lung hyperinflation and airflow limitation in COPD. V̇E/V̇CO2 intercept emerged as a useful index of ventilatory inefficiency across the severity spectrum of COPD patients.

scholarly journals Cardiopulmonary Response to Exercise in COPD and Overweight Patients: Relationship between Unloaded Cycling and Maximal Oxygen Uptake Profiles

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Abdoulaye Ba ◽  
Fabienne Brégeon ◽  
Stéphane Delliaux ◽  
Fallou Cissé ◽  
Abdoulaye Samb ◽  
...  
Keyword(s):  
Oxygen Uptake ◽  
Maximal Oxygen Uptake ◽  
Ventilatory Threshold ◽  
Minute Ventilation ◽  
Rehabilitation Program ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Exercise Rehabilitation ◽  
Copd Patients ◽  
Overweight Subjects

Cardiopulmonary response to unloaded cycling may be related to higher workloads. This was assessed in male subjects: 18 healthy sedentary subjects (controls), 14 hypoxemic patients with chronic obstructive pulmonary disease (COPD), and 31 overweight individuals (twelve were hypoxemic). They underwent an incremental exercise up to the maximal oxygen uptake (VO2max), preceded by a 2 min unloaded cycling period. Oxygen uptake (VO2), heart rate (HR), minute ventilation (VE), and respiratory frequency (fR) were averaged every 10 s. At the end of unloaded cycling period, HR increase was significantly accentuated in COPD and hypoxemic overweight subjects (resp.,+14±2and+13±1.5 min−1, compared to+7.5±1.5 min−1in normoxemic overweight subjects and+8±1.8 min−1in controls). The fR increase was accentuated in all overweight subjects (hypoxemic:+4.5±0.8; normoxemic:+3.9±0.7 min−1) compared to controls (+2.5±0.8 min−1) and COPDs (+2.0±0.7 min−1). The plateau VE increase during unloaded cycling was positively correlated with VE values measured at the ventilatory threshold and VO2max. Measurement of ventilation during unloaded cycling may serve to predict the ventilatory performance of COPD patients and overweight subjects during an exercise rehabilitation program.

scholarly journals Using step counters to promote physical activity and exercise capacity in patients with chronic obstructive pulmonary disease: a meta-analysis

2018 ◽  
Vol 12 ◽  
pp. 175346661878738 ◽  
Author(s):  
Shanhu Qiu ◽  
Xue Cai ◽  
Xuyi Wang ◽  
Can He ◽  
Martina Zügel ◽  
...  
Keyword(s):  
Physical Activity ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Exercise Capacity ◽  
Meta Analysis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Step Counter ◽  
Copd Patients ◽  
Severe Copd

Background: Although step counters are popularly employed for physical rehabilitation in chronic obstructive pulmonary disease (COPD) patients, their effectiveness is inconsistent and even questioned. This meta-analysis aimed to investigate whether step counter use increases physical activity or improves exercise capacity in COPD patients. Methods: Electronic databases were searched for randomized controlled trials that assessed the efficacy of step counter use in increasing physical activity or in improving exercise capacity. Data were aggregated using a random-effects model to get the overall effect sizes [standard mean difference (SMD) with 95% confidence interval (CI)], and subgroup analyses were performed. Results: A total of 15 trials enrolling 1316 patients with moderate to severe COPD were included. Step counter use increased physical activity compared with controls (SMD = 0.57, 95% CI 0.31–0.84), which is equal to a magnitude of 1026 steps/day in daily steps. It also enhanced exercise capacity with an effect size of 0.30 (95% CI 0.16–0.45), approximating to a magnitude of 11.6 m in the 6-min walking distance. Step counter use could augment physical activity (SMD = 0.64, 95% CI 0.19–1.08) and exercise capacity (SMD = 0.32, 95% CI 0.01–0.62) for patients receiving pulmonary rehabilitation. Yet it cannot enhance physical activity or exercise capacity in patients with severe COPD or among studies with intervention durations ⩾6 months (both p > 0.50). Conclusions: Step counter use increases physical activity and improves exercise capacity in COPD patients, at least in the short term, which supports the notion of recommending step counter use in COPD management.

Quadriceps muscle weakness and atrophy are associated with a differential epigenetic profile in advanced COPD

2015 ◽  
Vol 128 (12) ◽  
pp. 905-921 ◽  
Author(s):  
Ester Puig-Vilanova ◽  
Juana Martínez-Llorens ◽  
Pilar Ausin ◽  
Josep Roca ◽  
Joaquim Gea ◽  
...  
Keyword(s):  
Muscle Weakness ◽  
Vastus Lateralis ◽  
Muscle Growth ◽  
Quadriceps Muscle ◽  
Sirtuin 1 ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Epigenetic Events ◽  
Severe Copd

Epigenetic mechanisms regulate muscle mass and function in models of muscle dysfunction and atrophy. We assessed whether quadriceps muscle weakness and atrophy are associated with a differential expression profile of epigenetic events in patients with advanced COPD (chronic obstructive pulmonary disease). In vastus lateralis (VL) of sedentary severe COPD patients (n=41), who were further subdivided into those with (n=25) and without (n=16) muscle weakness and healthy controls (n=19), expression of muscle-enriched miRNAs, histone acetyltransferases (HATs) and deacetylases (HDACs), growth and atrophy signalling markers, total protein and histone acetylation, transcription factors, small ubiquitin-related modifier (SUMO) ligases and muscle structure were explored. All subjects were clinically evaluated. Compared with controls, in VL of all COPD together and in muscle-weakness patients, expression of miR-1, miR-206 and miR-27a, levels of lysine-acetylated proteins and histones and acetylated histone 3 were increased, whereas expression of HDAC3, HDAC4, sirtuin-1 (SIRT-1), IGF-1 (insulin-like growth factor-1) were decreased, Akt (v-akt murine thymoma viral oncogene homologue 1) expression did not differ, follistatin expression was greater, whereas myostatin expression was lower, serum reponse factor (SRF) expression was increased and fibre size of fast-twitch fibres was significantly reduced. In VL of severe COPD patients with muscle weakness and atrophy, epigenetic events regulate muscle differentiation rather than proliferation and muscle growth and atrophy signalling, probably as feedback mechanisms to prevent those muscles from undergoing further atrophy. Lysine-hyperacetylation of histones may drive enhanced protein catabolism in those muscles. These findings may help design novel therapeutic strategies (enhancers of miRNAs promoting myogenesis and acetylation inhibitors) to selectively target muscle weakness and atrophy in severe COPD.

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