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Ventilatory adaptation during eccentric cycling in patients with severe COPD: Potential implications for exercise training
Respiratory Physiology & Neurobiology ( IF 2.3 ) Pub Date : 2021-05-29 , DOI: 10.1016/j.resp.2021.103706
Olympe Nahmias 1 , Ophélie Ritter 2 , Yoshimasa Sagawa 3 , Pauline Roux 2 , Bruno Degano 4 , Thibaud Soumagne 2
Affiliation  

Introduction

Eccentric (ECC) cycling is viewed as an alternative to concentric (CON) cycling for exercise training in patients with severe COPD as it induces a much lower ventilatory demand for a given mechanical load than CON cycling. However, a more hyperpneic breathing pattern (i.e., higher fB and lower tidal volume (VT)) during ECC than during CON has been reported in healthy subjects.

Research question

Do patients with severe COPD develop a more hyperpneic breathing pattern during ECC than during CON cycling, and is it associated with differences in dynamic hyperinflation, ventilatory efficiency and cardiometabolic adaptation?

Methods

Fourteen patients with severe COPD performed incremental CON and ECC cardiopulmonary exercise tests (CPET). Several physiological parameters including VT, fB, inspiratory capacity (IC) and oxygen consumption (V̇O2) were recorded at each workload increment during CPET.

Results

At the highest identical minute ventilation (V̇E) achieved during ECC and CON (28.6 ± 4.6 L.min−1), VT was lower (1010 ± 218 vs. 1100 ± 233 mL; p = 0.02), fB was higher (29.0 ± 5.1 vs. 27.0 ± 5.5 min−1; p = 0.03), IC(% baseline) was lower (84 ± 10 vs. 78 ± 9; p < 0.01) and markers of ventilatory efficiency were poorer during ECC than during CON. Similar results were found at the highest identical V̇O2 achieved during ECC and CON.

Conclusion

The finding of a more hyperpneic ventilatory pattern during ECC cycling together with a lower IC and a poorer ventilatory efficiency suggests that ECC exercise training should be decided with caution in patients with severe COPD.



中文翻译:

重度 COPD 患者离心循环期间的通气适应:对运动训练的潜在影响

介绍

偏心 (ECC) 循环被视为同心 (CON) 循环的替代方案,用于严重 COPD 患者的运动训练,因为它对给定机械负荷的通气需求比 CON 循环低得多。然而,在健康受试者中报告了在 ECC 期间比在 CON 期间更过度呼吸的呼吸模式(更高的f B和更低的潮气量 (VT))。

研究问题

重度 COPD 患者在 ECC 期间是否会比在 CON 循环期间出现更多的过度呼吸模式,这是否与动态过度充气、通气效率和心脏代谢适应的差异有关?

方法

14 名重度 COPD 患者进行了增量 CON 和 ECC 心肺运动试验 (CPET)。在 CPET 期间,在每个工作量增量时记录了几个生理参数,包括 VT、f B、吸气量 (IC) 和耗氧量 (V̇O 2 )。

结果

在 ECC 和 CON 期间达到的最高相同分钟通气量 (V̇E) (28.6 ± 4.6 L.min -1 ),VT 较低 (1010 ± 218 vs. 1100 ± 233 mL;p = 0.02),f B较高 (29.0 ± 5.1 vs. 27.0 ± 5.5 min -1;p = 0.03),IC(基线百分比)较低(84 ± 10 vs. 78 ± 9 p < 0.01),ECC 期间的通气效率标志物比 CON 期间更差. 在 ECC 和 CON 期间达到的最高相同 V̇O 2发现了类似的结果。

结论

在 ECC 循环过程中发现更多的过度呼吸模式以及较低的 IC 和较差的通气效率,这表明在严重 COPD 患者中应谨慎决定 ECC 运动训练。

更新日期:2021-06-09
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