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Medizinische Universität Graz   Hilfe

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 Bestimmung der Peak Ventilation im Rahmen einer Ausbelastungsuntersuchung bei Patienten mit obstruktiver Ventilationsstörung  
 Abstract in Englisch

Background

In an exercise test, peak ventilation refers to the highest achieved ventilation over a period of 30 seconds. This ventilation can be a performance-limiting factor. Although peak ventilation is associated with many different factors like emphysema, muscle status, and age, there might be a significant correlation with FEV1 from pulmonary function testing at rest. The aim of this study is to answer the question, how the relationship between FEV1 in resting spirometry and peakVE during maximal exercise in COPD patients is, compared to healthy controls.



Materials and Methods

The FEV1, the highest achieved oxygen uptake (peakVO2), and the highest achieved ventilation (peakVE) were measured during routine spirometric and spiroergometric examinations conducted in the pneumological outpatient clinic of the University Clinic for Internal Medicine at the LKH University Hospital Graz. COPD patients who met the inclusion criteria were included and compared with 4 age- and sex-matched lung-healthy controls, respectively.

Results

A total number of 13 COPD patients were included and compared to 52 patients of the control group. There were highly significant differences at rest. FEV1 in the COPD patients was significantly reduced (x vs y percent predicted). In individuals with COPD, the arterial oxygen partial pressure was much lower. The COPD group's alveolo-arterial oxygen pressure differential was noticeably higher. Although the COPD group's respiratory rate was higher, the difference was not statistically significant. There were no discernible differences between the groups in the other measured parameters. The COPD group's Wattage (to measure their work on Ergometer) was statistically lower. As a result, as compared to the control group, the oxygen uptake was considerably lower in absolute or relative values. In COPD, the maximal heart rate was also markedly lowered. Along with a considerable decrease in tidal volume there was a reduction in peak ventilation, while peak breath rate was not changed. There was even a nominal modest rise in the respiratory rate. While the CO2 partial pressure was much higher in the COPD group, the oxygen partial pressure was significantly lower. Compared to the control group, the COPD group's BE decreased less during exercise. The COPD group experienced a rise in carbon dioxide partial pressure, whereas the control group decreased.

Conclusion

The important role of airflow limitation in exercise capacity was highlighted by this study, which found a substantial positive association between FEV1 and peak ventilation (peakVE) during exercise in both COPD patients and healthy controls, with a greater link shown in COPD patients. The complicated physiological variables restricting exercise in this population were highlighted by the considerably lower FEV1, peakVE, exercise performance, and gas exchange anomalies that COPD patients showed when compared to controls. A higher regression slope highlights the strong link between FEV1 and peakVE in COPD, which highlights the central role of airflow limitation for the ventilatory response to exercise.



 
 FEV1 – Forciertes exspiratorisches Volumen in 1 Sekunde. Maß für die Atemstromstärke. PeakVE – Maximale Minutenventilation während Belastung. VO2max / VO2peak – Maximale Sauerstoffaufnahmefähigkeit des Körpers unter Belastung. BE (Basenüberschuss) – Maß für den Säure-Basen-Haushalt. RV (Residualvolumen) – Luftvolumen, das nach maximaler Exspiration in der Lunge verbleibt.  
 
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Autorinnen*Autoren / Co-Autorinnen*Co-Autoren
  Souliman, Ahmed
Betreuende Einrichtung / Studium
  Universitätsklinik für Innere Medizin
 UO 996 202 Studium für die Gleichwertigkeit; Humanmedizin  
Betreuung / Beurteilung
  Foris, Vasile; Univ. FA Dr.-medic MSc PhD.
  Olschewski, Horst; Dr.med.