Increased physiological dead space at exercise is a marker of mild pulmonary or cardiovascular disease in dyspneic subjects

Background: The characteristics of cardiopulmonary exercise testing (CPET)-derived parameters for the differential diagnosis of exertional dyspnea are not well known. Objectives: We hypothesized that increased physiological dead space ventilation (VD/Vt) is a marker for mild pulmonary or cardiovascu...

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Main Authors: Laurent Plantier, Christophe Delclaux
Format: Article
Language:English
Published: Taylor & Francis Group 2018-01-01
Series:European Clinical Respiratory Journal
Subjects:
Online Access:http://dx.doi.org/10.1080/20018525.2018.1492842
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spelling doaj-c51711ff521741daadc93012df2cc5562020-11-25T00:27:03ZengTaylor & Francis GroupEuropean Clinical Respiratory Journal2001-85252018-01-015110.1080/20018525.2018.14928421492842Increased physiological dead space at exercise is a marker of mild pulmonary or cardiovascular disease in dyspneic subjectsLaurent Plantier0Christophe Delclaux1INSERM UMR 1152, Labex InflamexUniversité Paris Diderot, PRES Sorbonne Paris CitéBackground: The characteristics of cardiopulmonary exercise testing (CPET)-derived parameters for the differential diagnosis of exertional dyspnea are not well known. Objectives: We hypothesized that increased physiological dead space ventilation (VD/Vt) is a marker for mild pulmonary or cardiovascular disease in patients with exertional dyspnea. Design: We used receiver operating characteristic analysis to determine the performance of individual CPET parameters for identifying subjects with either mild pulmonary or cardiovascular disease, among 77 subjects with mild-to-moderate exertional dyspnea (modified Medical Research Council scale 1–2). Results: In comparison with subjects without disease, subjects with pulmonary disease (n = 31) had higher VE/V′CO2 slope, higher VD/Vt, and lower ventilatory reserve. Subjects with cardiovascular disease (n = 14) had lower heart rate and cardiovascular double product and higher VD/Vt at peak exercise. At a threshold of 28%, the sensitivity and specificity of VD/Vt at peak exercise for identifying pulmonary or cardiovascular disease were 89% (95% CI: 64–98%) and 72% (95% CI: 46–89%), respectively. Conclusions: Increased physiological VD/Vt at exercise is a sensitive and specific marker of mild pulmonary or cardiovascular disease in dyspneic subjects.http://dx.doi.org/10.1080/20018525.2018.1492842Dead spaceefficiencyexercisecardiopulmonary exercise testinglung diseasecardiovascular disease
collection DOAJ
language English
format Article
sources DOAJ
author Laurent Plantier
Christophe Delclaux
spellingShingle Laurent Plantier
Christophe Delclaux
Increased physiological dead space at exercise is a marker of mild pulmonary or cardiovascular disease in dyspneic subjects
European Clinical Respiratory Journal
Dead space
efficiency
exercise
cardiopulmonary exercise testing
lung disease
cardiovascular disease
author_facet Laurent Plantier
Christophe Delclaux
author_sort Laurent Plantier
title Increased physiological dead space at exercise is a marker of mild pulmonary or cardiovascular disease in dyspneic subjects
title_short Increased physiological dead space at exercise is a marker of mild pulmonary or cardiovascular disease in dyspneic subjects
title_full Increased physiological dead space at exercise is a marker of mild pulmonary or cardiovascular disease in dyspneic subjects
title_fullStr Increased physiological dead space at exercise is a marker of mild pulmonary or cardiovascular disease in dyspneic subjects
title_full_unstemmed Increased physiological dead space at exercise is a marker of mild pulmonary or cardiovascular disease in dyspneic subjects
title_sort increased physiological dead space at exercise is a marker of mild pulmonary or cardiovascular disease in dyspneic subjects
publisher Taylor & Francis Group
series European Clinical Respiratory Journal
issn 2001-8525
publishDate 2018-01-01
description Background: The characteristics of cardiopulmonary exercise testing (CPET)-derived parameters for the differential diagnosis of exertional dyspnea are not well known. Objectives: We hypothesized that increased physiological dead space ventilation (VD/Vt) is a marker for mild pulmonary or cardiovascular disease in patients with exertional dyspnea. Design: We used receiver operating characteristic analysis to determine the performance of individual CPET parameters for identifying subjects with either mild pulmonary or cardiovascular disease, among 77 subjects with mild-to-moderate exertional dyspnea (modified Medical Research Council scale 1–2). Results: In comparison with subjects without disease, subjects with pulmonary disease (n = 31) had higher VE/V′CO2 slope, higher VD/Vt, and lower ventilatory reserve. Subjects with cardiovascular disease (n = 14) had lower heart rate and cardiovascular double product and higher VD/Vt at peak exercise. At a threshold of 28%, the sensitivity and specificity of VD/Vt at peak exercise for identifying pulmonary or cardiovascular disease were 89% (95% CI: 64–98%) and 72% (95% CI: 46–89%), respectively. Conclusions: Increased physiological VD/Vt at exercise is a sensitive and specific marker of mild pulmonary or cardiovascular disease in dyspneic subjects.
topic Dead space
efficiency
exercise
cardiopulmonary exercise testing
lung disease
cardiovascular disease
url http://dx.doi.org/10.1080/20018525.2018.1492842
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