Asymptomatic subjects with airway obstruction have significant impairment at exercise.

Thibaud Soumagne (1) , Pierantonio Laveneziana (2, 3) , Matthieu Veil-Picard , Alicia Guillien (1) , Frédéric Claudé (4) , Marc Puyraveau (5, 1) , Isabella Annesi-Maesano (6) , Nicolas Roche (7) , Jean-Charles Dalphin (8) , Bruno Degano (9)

1 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
2 CHU Pitié-Salpêtrière [AP-HP]
3 Neurophysiologie Respiratoire Expérimentale et Clinique
4 IC2MP [Poitiers] - Institut de chimie des milieux et matériaux de Poitiers [UMR 7285]
5 CEF2P / CARCINO - Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181)
6 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
7 EA 2511 - Mucoviscidose et bronchopathies chroniques : biopathologie et phénotypes cliniques
8 LCE - Laboratoire Chrono-environnement (UMR 6249)
9 PCVP / CARDIO - Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( UR 3920)

The relevance of screening for airway obstruction in subjects not complaining of COPD symptoms may depend on the definition of airway obstruction. Response to exercise in asymptomatic subjects with persistent airway obstruction as defined by a postbronchodilator FEV1/FVC <5th centile lower limit of normal (LLN) remains unknown. Dyspnoea (Borg scale), exercise tolerance and ventilatory constraints on tidal volume expansion were assessed in 20 consecutive asymptomatic subjects with persistent mild airway obstruction detected by screening (postbronchodilator FEV1/FVC z-score: -2.14±0.29; FEV1 z-score: -1.02±0.64) undergoing incremental cycle cardiopulmonary exercise testing, compared with 20 healthy controls with normal spirometry matched for age, sex, body mass index and smoking history (FEV1/FVC z-score: -0.13±0.57; FEV1 z-score: 0.32±0.67) and with 20 symptomatic patients with COPD matched for the same characteristics (FEV1/FVC z-score: -2.36±0.51; FEV1 z-score: -1.02±0.48). Asymptomatic subjects with airway obstruction had higher dyspnoea ratings than controls during incremental exercise. Asymptomatic subjects with airway obstruction had also peak oxygen consumption and peak power output that were lower than controls, and similar to those observed in patients with COPD. Although less frequent than in COPD, dynamic hyperinflation was more frequent in asymptomatic subjects with airway obstruction than in controls (85%, 50% and 10%, respectively; p=0.01 in asymptomatic subjects vs controls and p=0.04 vs COPD). Although they did not present with chronic activity-related dyspnoea, subjects with a postbronchodilator FEV1/FVC

Domaines: Santé

Thibaud Soumagne, Pierantonio Laveneziana, Matthieu Veil-Picard, Alicia Guillien, Frédéric Claudé, et al.. Asymptomatic subjects with airway obstruction have significant impairment at exercise.. Thorax, 2016, 71 (9), pp.804-11. ⟨10.1136/thoraxjnl-2015-207953⟩. ⟨hal-01368336⟩