Exhaled nitric oxide and exercise tolerance in severe COPD patients

E. Clini, L. Bianchi, K. Foglio, M. Vitacca, N. Ambrosino

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To answer the question as to whether pulmonary rehabilitation programs (PRP) induced increase in exercise tolerance (ET) is associated with increased levels of exhaled nitric oxide (eNO) in COPD patients of different degrees of severity, we designed a prospective and controlled study. Forty-seven stable COPD patients underwent an 8-week outpatient multidisciplinary PRP including supervised incremental exercise. Fractional eNO concentration (FENO) and peak work-rate (Wpeak) were assessed baseline (T-I), at the end of 1-month run-in period (TO), and after (TI) the PRP. Lung function, walking test, health-related quality of life (HRQL) were also recorded. Patients were divided into three groups according to disease severity: 17 severe [FEV1 35 (5)% pred] COPD patients, seven of them with cor pulmonale; 15 mild [FEV1 78 (6)% pred], and 15 moderate [FEV1 56 (6)% pred] COPD patients. FENO did not differ at T-I and TO (mean absolute change (SD): 0.03 (0.09) 95% CI-0.01, 0.16, 0.06 (1.03) 95% CI 0.03, 0.75 and 0.05 (0.06) 95% CI 0.02, 0.11 ppb in mild, moderate and severe patients, respectively). As compared to TO, both Wpeak (by 17,15 and 10%, respectively) and FENO (by 29, 24 and 16%, respectively) significantly increased in all groups, but not in patients with cor pulmonale. A significant correlation between pre- and post-PRP changes in Wpeak and FENO was found both in mild to moderate (r=0.79, P

Original languageEnglish
Pages (from-to)312-316
Number of pages5
JournalRespiratory Medicine
Issue number5
Publication statusPublished - May 2002


  • Airway obstruction
  • Chemiluminescence analysis
  • Exercise training

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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