| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Guest Access | Sign In via User Name/Password
|
|
|
|||||||
Guest Access | Sign In via User Name/Password |
|||||||||
* From the Division of Cardiovascular Disease (Dr. Johnson), and the Division of Thoracic Disease (Dr. Beck), Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN; Department of Clinical Investigation (Drs. Weisman and Zeballos), Human Performance Laboratory, William Beaumont Army Medical Center, El Paso, TX.
Correspondence to: Bruce D. Johnson, PhD, Division of Cardiovascular Diseases, Baldwin 2B, Mayo Clinic and Foundation, Rochester, MN 55905; e-mail: johnson.bruce{at}mayo.edu
Traditionally, ventilatory limitation (constraint) during
exercise has been determined by measuring the ventilatory reserve or
how close the minute ventilation (
E) achieved during
exercise (ie, ventilatory demand) approaches the maximal
voluntary ventilation (MVV) or some estimate of the MVV
(ie, ventilatory capacity). More recently, it has become
clear that rarely is the MVV breathing pattern adopted during exercise
and that the E/MVV relationship tells little about
the specific reason(s) for ventilatory constraint. Although it is not a
new concept, by measuring the tidal exercise flow-volume (FV) loops
(extFVLs) obtained during exercise and plotting them according to a
measured end-expiratory lung volume (EELV) within the maximal FV
envelope (MFVL), more specific information is provided on the sources
(and degree) of ventilatory constraint. This includes the extent of
expiratory flow limitation, inspiratory flow reserve, alterations in
the regulation of EELV (dynamic hyperinflation), end-inspiratory lung
volume relative to total lung capacity (or tidal volume/inspiratory
capacity), and a proposed estimate of ventilatory capacity based on the
shape of the MFVL and the breathing pattern adopted during exercise. By
assessing these types of changes, the degree of ventilatory constraint
can be quantified and a more thorough interpretation of the
cardiopulmonary exercise response is possible. This review will focus
on the potential role of plotting the extFVL within the MFVL for
determination of ventilatory constraint during exercise in the clinical
setting. Important physiologic concepts, measurements, and limitations
obtained from this type of analysis will be defined and
discussed.
Key Words: dynamic hyperinflation • end-expiratory lung volume • exercise • flow limitation • ventilatory capacity • ventilatory limitation
This article has been cited by other articles:
|
|
 |
|
  J. A. Guenette, J. D. Witt, D. C. McKenzie, J. D. Road, and A. W. Sheel Respiratory mechanics during exercise in endurance-trained men and women J. Physiol., June 15, 2007; 581(3): 1309 - 1322. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Nourry, F. Deruelle, C. Fabre, G. Baquet, F. Bart, J.-M. Grosbois, S. Berthoin, and P. Mucci Exercise flow-volume loops in prepubescent aerobically trained children J Appl Physiol, November 1, 2005; 99(5): 1912 - 1921. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Maltais, A. Hamilton, D. Marciniuk, P. Hernandez, F. C. Sciurba, K. Richter, S. Kesten, and D. O'Donnell Improvements in Symptom-Limited Exercise Performance Over 8 h With Once-Daily Tiotropium in Patients With COPD Chest, September 1, 2005; 128(3): 1168 - 1178. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. F. McKone, S. C. Barry, M. X. FitzGerald, and C. G. Gallagher Role of arterial hypoxemia and pulmonary mechanics in exercise limitation in adults with cystic fibrosis J Appl Physiol, September 1, 2005; 99(3): 1012 - 1018. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Verges, G. Devouassoux, P. Flore, E. Rossini, M. Fior-Gozlan, P. Levy, and B. Wuyam Bronchial Hyperresponsiveness, Airway Inflammation, and Airflow Limitation in Endurance Athletes Chest, June 1, 2005; 127(6): 1935 - 1941. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. P. Sexauer, H.-K. Cheng, and S. B. Fiel Utility of the Breathing Reserve Index at the Anaerobic Threshold in Determining Ventilatory-Limited Exercise in Adult Cystic Fibrosis Patients Chest, October 1, 2003; 124(4): 1469 - 1475. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 ATS/ACCP Statement on Cardiopulmonary Exercise Testing Am. J. Respir. Crit. Care Med., January 15, 2003; 167(2): 211 - 277. [Full Text] [PDF]
|
|
|
|
|
|
A. Corsico, P. Fulgoni, M. Beccaria, M. C. Zoia, G. Barisione, R. Pellegrino, V. Brusasco, and I. Cerveri Effects of exercise and beta 2-agonists on lung function in chronic obstructive pulmonary disease J Appl Physiol, December 1, 2002; 93(6): 2053 - 2058. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. D. Sin, R. L. Jones, and S. F. P. Man Obesity Is a Risk Factor for Dyspnea but Not for Airflow Obstruction Arch Intern Med, July 8, 2002; 162(13): 1477 - 1481. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Crimi, R. Pellegrino, A. Smeraldi, and V. Brusasco Exercise-induced bronchodilation in natural and induced asthma: effects on ventilatory response and performance J Appl Physiol, June 1, 2002; 92(6): 2353 - 2360. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Miller, K. C. Beck, M. J. Joyner, A. G. Brice, and B. D. Johnson Cardiorespiratory effects of inelastic chest wall restriction J Appl Physiol, June 1, 2002; 92(6): 2419 - 2428. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Abdel Kafi, T. Serste, D. Leduc, R. Sergysels, and V. Ninane Expiratory flow limitation during exercise in COPD: detection by manual compression of the abdominal wall Eur. Respir. J., May 1, 2002; 19(5): 919 - 927. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. E. Dolmage and R. S. Goldstein Repeatability of Inspiratory Capacity During Incremental Exercise in Patients With Severe COPD Chest, March 1, 2002; 121(3): 708 - 714. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. D. Johnson, K. C. Beck, R. J. Zeballos, and I. M. Weisman Advances in Pulmonary Laboratory Testing Chest, November 1, 1999; 116(5): 1377 - 1387. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
