Chest
Original ResearchCOPDOptimal Protocol Selection for Cardiopulmonary Exercise Testing in Severe COPD
Section snippets
Materials and Methods
Eleven stable subjects (5 women, 6 men) with severe COPD (Global Initiative for Chronic Obstructive Lung Disease stage III–IV) were recruited for the study based on history, and findings of physical examination, chest radiographs, and pulmonary function testing. No subjects were receiving long-term oxygen therapy. Spirometry and single-breath diffusing capacity of the lung for carbon monoxide (corrected for hemoglobin) were performed in all subjects ( max 6200; SensorMedics; Yorba Linda,
Subject Characteristics
Baseline characteristics of the study group are shown in Table 1.
Duration of the Exercise Tests
The mean duration for all 44 tests was 6 min (95% CI, 5 to 9 min). The test durations also differed significantly according to the protocol used (p < 0.001): 16-W ramp protocol, 4.0 min (95% CI, 3.0 to 5.1 min); 8-W ramp protocol, 6.6 min (95% CI, 5.0 to 9.0 min); 8-W step protocol, 6.0 min (95% CI, 4.0 to 8.0 min); and 4-W ramp protocol, 8.7 min (95% CI, 4.4 to 13.0 min). Thirty-three of the 44 tests (75%) lasted < 8 min.
Discussion
In this study, o2peak, in a group of patients with severe COPD, was achieved in a shorter time frame than that proposed in the current exercise guidelines.10 The mean duration of CPET in our study based on 44 carefully executed tests was 6.3 min (95% CI, 5.0 to 9.0 min) [Fig 1]. This is shorter than the recommended duration of 8 to 12 min for CPET10 that was based on the only available data from a group of five healthy subjects.11 We found no significant differences in the o2peak
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2011, International Journal of CardiologyCitation Excerpt :In addition, exercise time in the CPET group was shorter than the recommended 8–12 min [34], which may have had impact on the measurement of peak VO2. However, a recent study suggested that in patients with COPD, exercise time seems not to be critical for the assessment of peak VO2 [35]. Second, we used cycle exercise, whereas other studies on exercise-induced changes in natriuretic peptides used treadmill exercise [9,10], and thus our findings might not be directly applicable to treadmill exercise.
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Dr. Benzo is supported by grant No. 5k23CA106544 from the National Institutes of Health. Dr. Sciurba is supported by grant No. 1P50HL084948-0 from the National Institutes of Health.
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.