Role of hyperinflation vs. deflation on dyspnoea in severely to extremely obese subjects

I. Romagnoli, P. Laveneziana, E. M. Clini, P. Palange, G. Valli, F. De Blasio, F. Gigliotti, G. Scano

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Aim: To test the hypothesis that obese individuals may either hyperinflate or deflate the lung when exercising. In both cases breathlessness is an inescapable consequence. Methods: Ventilatory variables, end-expiratory lung volume and end-inspiratory lung volume, and dyspnoea score (Borg scale) were studied in 20 class II-III obese subjects and 14 healthy controls during incremental symptom-limited cycle exercise. Results: Ventilation increased with increasing work rate, in obese and in control subjects; most obese subjects had to increase end-expiratory lung volume to escape from flow limitation; in contrast, like controls, a few subjects deflated the lung on heavy-to-peak exercise. Dyspnoea was equal in degree at anaerobic threshold and peak exercise in obese as in control subjects, and in obese who hyperinflated as in those who deflated the lung. In particular, end-expiratory lung volume at baseline (r = -0.84, P = 0.04) was negatively correlated with changes in Borg score in obese who did not hyperinflate: the lower the former the higher the latter. On the other hand, tidal volume (r = 0.54, P = 0.045) and decrease in inspiratory reserve volume (r = 0.59, P = 0.028) were positively correlated with the Borg score in obese subjects who hyperinflated. No other independent variable correlated with the Borg score. Conclusions: We conclude that not all obese subjects had to increase end-expiratory lung volume on heavy-to-peak exercise. Changes in dyspnoea for unit changes in ventilation were similar in obese who did hyperinflate as well as in those who did not, suggesting that the increase in respiratory neural drive, associated with an increase in ventilation, is an important source of dyspnoea in obese as well as in control subjects.

Original languageEnglish
Pages (from-to)393-402
Number of pages10
JournalActa Physiologica
Volume193
Issue number4
DOIs
Publication statusPublished - Aug 2008

Fingerprint

Dyspnea
Lung
Exercise
Ventilation
Inspiratory Reserve Volume
Anaerobic Threshold
Tidal Volume
Healthy Volunteers

Keywords

  • Exercise capacity
  • Expiratory flow limitation
  • Hyperinflation
  • Leg discomfort
  • Operational lung volumes
  • Ventilation

ASJC Scopus subject areas

  • Physiology

Cite this

Romagnoli, I., Laveneziana, P., Clini, E. M., Palange, P., Valli, G., De Blasio, F., ... Scano, G. (2008). Role of hyperinflation vs. deflation on dyspnoea in severely to extremely obese subjects. Acta Physiologica, 193(4), 393-402. https://doi.org/10.1111/j.1748-1716.2008.01852.x

Role of hyperinflation vs. deflation on dyspnoea in severely to extremely obese subjects. / Romagnoli, I.; Laveneziana, P.; Clini, E. M.; Palange, P.; Valli, G.; De Blasio, F.; Gigliotti, F.; Scano, G.

In: Acta Physiologica, Vol. 193, No. 4, 08.2008, p. 393-402.

Research output: Contribution to journalArticle

Romagnoli, I, Laveneziana, P, Clini, EM, Palange, P, Valli, G, De Blasio, F, Gigliotti, F & Scano, G 2008, 'Role of hyperinflation vs. deflation on dyspnoea in severely to extremely obese subjects', Acta Physiologica, vol. 193, no. 4, pp. 393-402. https://doi.org/10.1111/j.1748-1716.2008.01852.x
Romagnoli I, Laveneziana P, Clini EM, Palange P, Valli G, De Blasio F et al. Role of hyperinflation vs. deflation on dyspnoea in severely to extremely obese subjects. Acta Physiologica. 2008 Aug;193(4):393-402. https://doi.org/10.1111/j.1748-1716.2008.01852.x
Romagnoli, I. ; Laveneziana, P. ; Clini, E. M. ; Palange, P. ; Valli, G. ; De Blasio, F. ; Gigliotti, F. ; Scano, G. / Role of hyperinflation vs. deflation on dyspnoea in severely to extremely obese subjects. In: Acta Physiologica. 2008 ; Vol. 193, No. 4. pp. 393-402.
@article{2c2e62bd92ae4ae894b33b0b209966c7,
title = "Role of hyperinflation vs. deflation on dyspnoea in severely to extremely obese subjects",
abstract = "Aim: To test the hypothesis that obese individuals may either hyperinflate or deflate the lung when exercising. In both cases breathlessness is an inescapable consequence. Methods: Ventilatory variables, end-expiratory lung volume and end-inspiratory lung volume, and dyspnoea score (Borg scale) were studied in 20 class II-III obese subjects and 14 healthy controls during incremental symptom-limited cycle exercise. Results: Ventilation increased with increasing work rate, in obese and in control subjects; most obese subjects had to increase end-expiratory lung volume to escape from flow limitation; in contrast, like controls, a few subjects deflated the lung on heavy-to-peak exercise. Dyspnoea was equal in degree at anaerobic threshold and peak exercise in obese as in control subjects, and in obese who hyperinflated as in those who deflated the lung. In particular, end-expiratory lung volume at baseline (r = -0.84, P = 0.04) was negatively correlated with changes in Borg score in obese who did not hyperinflate: the lower the former the higher the latter. On the other hand, tidal volume (r = 0.54, P = 0.045) and decrease in inspiratory reserve volume (r = 0.59, P = 0.028) were positively correlated with the Borg score in obese subjects who hyperinflated. No other independent variable correlated with the Borg score. Conclusions: We conclude that not all obese subjects had to increase end-expiratory lung volume on heavy-to-peak exercise. Changes in dyspnoea for unit changes in ventilation were similar in obese who did hyperinflate as well as in those who did not, suggesting that the increase in respiratory neural drive, associated with an increase in ventilation, is an important source of dyspnoea in obese as well as in control subjects.",
keywords = "Exercise capacity, Expiratory flow limitation, Hyperinflation, Leg discomfort, Operational lung volumes, Ventilation",
author = "I. Romagnoli and P. Laveneziana and Clini, {E. M.} and P. Palange and G. Valli and {De Blasio}, F. and F. Gigliotti and G. Scano",
year = "2008",
month = "8",
doi = "10.1111/j.1748-1716.2008.01852.x",
language = "English",
volume = "193",
pages = "393--402",
journal = "Acta Physiologica Scandinavica",
issn = "0370-839X",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Role of hyperinflation vs. deflation on dyspnoea in severely to extremely obese subjects

AU - Romagnoli, I.

AU - Laveneziana, P.

AU - Clini, E. M.

AU - Palange, P.

AU - Valli, G.

AU - De Blasio, F.

AU - Gigliotti, F.

AU - Scano, G.

PY - 2008/8

Y1 - 2008/8

N2 - Aim: To test the hypothesis that obese individuals may either hyperinflate or deflate the lung when exercising. In both cases breathlessness is an inescapable consequence. Methods: Ventilatory variables, end-expiratory lung volume and end-inspiratory lung volume, and dyspnoea score (Borg scale) were studied in 20 class II-III obese subjects and 14 healthy controls during incremental symptom-limited cycle exercise. Results: Ventilation increased with increasing work rate, in obese and in control subjects; most obese subjects had to increase end-expiratory lung volume to escape from flow limitation; in contrast, like controls, a few subjects deflated the lung on heavy-to-peak exercise. Dyspnoea was equal in degree at anaerobic threshold and peak exercise in obese as in control subjects, and in obese who hyperinflated as in those who deflated the lung. In particular, end-expiratory lung volume at baseline (r = -0.84, P = 0.04) was negatively correlated with changes in Borg score in obese who did not hyperinflate: the lower the former the higher the latter. On the other hand, tidal volume (r = 0.54, P = 0.045) and decrease in inspiratory reserve volume (r = 0.59, P = 0.028) were positively correlated with the Borg score in obese subjects who hyperinflated. No other independent variable correlated with the Borg score. Conclusions: We conclude that not all obese subjects had to increase end-expiratory lung volume on heavy-to-peak exercise. Changes in dyspnoea for unit changes in ventilation were similar in obese who did hyperinflate as well as in those who did not, suggesting that the increase in respiratory neural drive, associated with an increase in ventilation, is an important source of dyspnoea in obese as well as in control subjects.

AB - Aim: To test the hypothesis that obese individuals may either hyperinflate or deflate the lung when exercising. In both cases breathlessness is an inescapable consequence. Methods: Ventilatory variables, end-expiratory lung volume and end-inspiratory lung volume, and dyspnoea score (Borg scale) were studied in 20 class II-III obese subjects and 14 healthy controls during incremental symptom-limited cycle exercise. Results: Ventilation increased with increasing work rate, in obese and in control subjects; most obese subjects had to increase end-expiratory lung volume to escape from flow limitation; in contrast, like controls, a few subjects deflated the lung on heavy-to-peak exercise. Dyspnoea was equal in degree at anaerobic threshold and peak exercise in obese as in control subjects, and in obese who hyperinflated as in those who deflated the lung. In particular, end-expiratory lung volume at baseline (r = -0.84, P = 0.04) was negatively correlated with changes in Borg score in obese who did not hyperinflate: the lower the former the higher the latter. On the other hand, tidal volume (r = 0.54, P = 0.045) and decrease in inspiratory reserve volume (r = 0.59, P = 0.028) were positively correlated with the Borg score in obese subjects who hyperinflated. No other independent variable correlated with the Borg score. Conclusions: We conclude that not all obese subjects had to increase end-expiratory lung volume on heavy-to-peak exercise. Changes in dyspnoea for unit changes in ventilation were similar in obese who did hyperinflate as well as in those who did not, suggesting that the increase in respiratory neural drive, associated with an increase in ventilation, is an important source of dyspnoea in obese as well as in control subjects.

KW - Exercise capacity

KW - Expiratory flow limitation

KW - Hyperinflation

KW - Leg discomfort

KW - Operational lung volumes

KW - Ventilation

UR - http://www.scopus.com/inward/record.url?scp=48449098195&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=48449098195&partnerID=8YFLogxK

U2 - 10.1111/j.1748-1716.2008.01852.x

DO - 10.1111/j.1748-1716.2008.01852.x

M3 - Article

C2 - 18363899

AN - SCOPUS:48449098195

VL - 193

SP - 393

EP - 402

JO - Acta Physiologica Scandinavica

JF - Acta Physiologica Scandinavica

SN - 0370-839X

IS - 4

ER -