Exertional breathlessness is a cardinal symptom of cardiorespiratory disease. How does breathlessness abnormality, graded using normative reference equations during cardiopulmonary exercise testing (CPET), relate to self-reported and physiologic responses in people with chronic airflow limitation (CAL)? An analysis was done of people aged ≥ 40 years with CAL undergoing CPET in the Canadian Cohort Obstructive Lung Disease study. Breathlessness intensity ratings (Borg CR10 scale [0-10 category-ratio scale for breathlessness intensity rating]) were evaluated in relation to power output, rate of oxygen uptake, and minute ventilation at peak exercise, using normative reference equations as follows: (1) probability of breathlessness normality (probability of having an equal or greater Borg CR10 rating among healthy people; lower probability reflecting more severe breathlessness) and (2) presence of abnormal breathlessness (rating above the upper limit of normal). Associations with relevant participant-reported and physiologic outcomes were evaluated. We included 330 participants (44% women): mean ± SD age, 64 ± 10 years (range, 40–89 years); FEV/FVC, 57.3% ± 8.2%; FEV, 75.6% ± 17.9% predicted. Abnormally low exercise capacity (peak rate of oxygen uptake < lower limit of normal) was present in 26%. Relative to peak power output, rate of oxygen uptake, and minute ventilation, abnormally high breathlessness was present in 26%, 25%, and 18% of participants. For all equations, abnormally high exertional breathlessness was associated with worse lung function, exercise capacity, self-reported symptom burden, physical activity, and health-related quality of life; and greater physiologic abnormalities during CPET. Abnormal breathlessness graded using CPET normative reference equations was associated with worse clinical, physiological, and functional outcomes in people with CAL, supporting construct validity of abnormal exertional breathlessness.

中文翻译：

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心肺循环运动测试中的异常劳力性呼吸困难与慢性气流受限的自我报告和生理反应相关


劳力性呼吸困难是心肺疾病的主要症状。心肺运动测试 (CPET) 期间使用规范参考方程分级的呼吸困难异常与慢性气流受限 (CAL) 患者的自我报告和生理反应有何关系？在加拿大队列阻塞性肺病研究中，对年龄≥ 40 岁的 CAL 患者接受 CPET 进行了分析。呼吸困难强度评级（Borg CR10 量表[呼吸困难强度评级的 0-10 类别比例量表]）根据功率输出、摄氧率和峰值运动时的每分钟通气量进行评估，使用规范参考方程如下：（1 ) 呼吸困难正常的概率（健康人群中具有相同或更高 Borg CR10 评级的概率；较低的概率反映更严重的呼吸困难）和 (2) 存在异常呼吸困难（评级高于正常上限）。评估了与相关参与者报告和生理结果的关联。我们纳入了 330 名参与者（44% 女性）：平均±SD 年龄，64±10 岁（范围，40-89 岁）； FEV/FVC，57.3% ± 8.2%； FEV，预计为 75.6% ± 17.9%。 26% 的人存在异常低的运动能力（最高摄氧率<正常下限）。相对于峰值功率输出、摄氧率和分钟通气量，26%、25% 和 18% 的参与者出现异常高的呼吸困难。对于所有方程，异常高的劳力性呼吸困难与较差的肺功能、运动能力、自我报告的症状负担、身体活动和健康相关的生活质量相关； CPET 期间出现更严重的生理异常。 使用 CPET 规范参考方程分级的异常呼吸困难与 CAL 患者较差的临床、生理和功能结果相关，这支持了异常劳力性呼吸困难的结构有效性。