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Decreased respiratory efficiency can lead to shortness of breath, even in cases of mild COPD

Decreased respiratory efficiency can lead to shortness of breath, even in cases of mild COPD

Results of the CanCOLD study conducted in AJRCCM publication, showing that decreased respiratory efficiency with exercise can cause shortness of breath and exercise limitation, even in mild COPD.

Participants were randomly recruited from the population and underwent clinical assessment, lung function measurements, cardiopulmonary exercise testing, and chest computed tomography. Reduced respiratory efficiency during exercise was determined by trough carbon dioxide2 Above the upper limit of normal (ULN).

Of the participants, 445 subjects had never smoked, 381 had never smoked but had no airway obstruction, and 224 had COPD GOLD Stage 1 and 200 GOLD Stage 2-4. Participants with CO2 Above the ULN were more likely to have dyspnea on exertion (MRC dyspnea scale ≥ 2; OR 1.77) and an abnormally low peak O2 Below the minimum normal (4.58 Ra). Kco had a stronger relationship with nadir CO2 (r = -0.38; p < 0.001) from other relevant measurements of lung function and CT scan.
CO . spread2 Higher than the ULN was 24% in COPD. This ratio was similar in subjects with COPD GOLD 1 and 2-4. The prevalence of COPD was higher than that of non-smokers (13%) and permanent smokers (12%).

source:

Phillips DB, Elbehairy AF, James MD et al. Impaired breathing, dyspnea, and exercise intolerance in chronic obstructive pulmonary disease: results from the CanCOLD study. Am J Respir Crit Care Med. 2022; 205: 1391-1402.

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