Exertional Dyspnoea responses reported in the Dyspnoea Challenge and measures of disease severity in COPD
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Walsh, James R
Stewart, Glenn M
Sabapathy, Surendran
Adams, Lewis
Morris, Norman R
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Abstract
Background: The Dyspnoea Challenge has been developed to facilitate the field-based measure of exertional dyspnoea(ED). To further validate the test, we aimed to; investigate the relationship between end-exercise ED, generated by a fixed-intensity Dyspnoea Challenge(DCFIX), and measures of disease severity (Forced expiratory volume in 1 s(FEV1), six-minute walk distance(6MWD), breathing reserve(V̇E/MVV), modified medical research council dyspnoea scale (mMRC), Body-mass index, airflow Obstruction, Dyspnoea, and Exercise (BODE index) and compare the physiological response of the DCFIX to a six-minute walk test(6MWT). Methods: Thirty-two individuals (15 female) with COPD (GOLD II-IV) (age: 69.7 ± 9.4 yrs; FEV1: 49.1 ± 18.2 %) performed 2×6MWT and 2xDCFIX at a treadmill speed of 3 km h−1 and gradient of 4 %. The intensity of ED was measured using the modified Borg dyspnoea scale at baseline and end-exercise with heart rate (HR) and oxygen saturation (SpO2) monitored continuously. During 1×6MWT and 1xDCFIX pulmonary gas exchange, cardiac output (Q̇) and dynamic hyperinflation were measured. Results: End-exercise ED measured during the DCFIX was not correlated to FEV1, but moderately correlated to; 6MWD(rs = −0.54, P <.01), V̇E/MVV (rs = 0.46, P =.02), mMRC(rs = 0.45, P =.01), and the BODE index(rs = 0.53, P <.01). When comparing the DCFIX and 6MWT, participants walked to comparable levels of oxygen consumption(P =.38), ventilation(P =.37), Q̇(P =.20), V̇E/MVV(P =.83), maximum HR percentages(P =.67) and dynamically hyperinflated to a similar degree(P =.37). Conclusions: The Dyspnoea Challenge is correlated to different parameters of disease severity and produces a similar physiological and ED response to that of the 6MWT with the added benefit of being appropriate for longitudinal assessment of ED.
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Respiratory Physiology & Neurobiology
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304
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Respiratory diseases
Medical physiology
Cardiovascular medicine and haematology
Science & Technology
Life Sciences & Biomedicine
Physiology
Respiratory System
Exertional dyspnoea
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Aitken, CR; Walsh, JR; Stewart, GM; Sabapathy, S; Adams, L; Morris, NR, Exertional Dyspnoea responses reported in the Dyspnoea Challenge and measures of disease severity in Respiratory Physiology & Neurobiology, 2022, 304, pp. 103941