INTRODUCTION/ PURPOSE: Hyperpnea and hyperinflation have been proposed as contributors to exaggerated energy demands in chronic obstructive pulmonary disease (COPD), yet there are incomplete data on exercise requirements. This study compared total-body energy demands of the internal (unloaded) and external work of cycling and delta mechanical efficiency in 40 patients (FEV1: 36+/-14% predicted) with COPD and 28 healthy age-matched controls while characterizing dynamic hyperinflation. METHODS: Steady-state V O2 was obtained at rest, during unloaded and 20-W cycling, and at 20, 50, and 65% peak cycling power. Delta mechanical efficiency was calculated between constant-load cycling at 65 and 20% peak power. Dynamic hyperinflation was assessed from inspiratory capacity maneuvers. RESULTS: Oxygen demands (L.min) at rest, for internal work (0.47+/-0.14 vs 0.45+/-0.11) or external work at 20 W (0.62+/-0.20 vs 0.57+/-0.13), were not different between patients and controls, although ventilation was elevated in COPD. Cycling at 65% of peak power induced dynamic hyperinflation in COPD, which indices were not related to cycling efficiency. Delta efficiency (%) was not different between patients (26.3+/-8.1) and controls (24.8+/-4.0). CONCLUSION: Findings suggest that bioenergetics of submaximal cycling is not compromised in moderately severe COPD despite tachypnea and dynamic hyperinflation.
INTRODUCTION/ PURPOSE: Hyperpnea and hyperinflation have been proposed as contributors to exaggerated energy demands in chronic obstructive pulmonary disease (COPD), yet there are incomplete data on exercise requirements. This study compared total-body energy demands of the internal (unloaded) and external work of cycling and delta mechanical efficiency in 40 patients (FEV1: 36+/-14% predicted) with COPD and 28 healthy age-matched controls while characterizing dynamic hyperinflation. METHODS: Steady-state V O2 was obtained at rest, during unloaded and 20-W cycling, and at 20, 50, and 65% peak cycling power. Delta mechanical efficiency was calculated between constant-load cycling at 65 and 20% peak power. Dynamic hyperinflation was assessed from inspiratory capacity maneuvers. RESULTS:Oxygen demands (L.min) at rest, for internal work (0.47+/-0.14 vs 0.45+/-0.11) or external work at 20 W (0.62+/-0.20 vs 0.57+/-0.13), were not different between patients and controls, although ventilation was elevated in COPD. Cycling at 65% of peak power induced dynamic hyperinflation in COPD, which indices were not related to cycling efficiency. Delta efficiency (%) was not different between patients (26.3+/-8.1) and controls (24.8+/-4.0). CONCLUSION: Findings suggest that bioenergetics of submaximal cycling is not compromised in moderately severe COPD despite tachypnea and dynamic hyperinflation.
Authors: Hayley Lewthwaite; Emily M Koch; Magnus Ekström; Alan Hamilton; Jean Bourbeau; François Maltais; Benoit Borel; Dennis Jensen Journal: J Thorac Dis Date: 2020-05 Impact factor: 3.005