Exertional dyspnoea in COPD: the clinical utility of cardiopulmonary exercise testing.

摘要: Activity-related dyspnoea is often the most distressing symptom experienced by patients with chronic obstructive pulmonary disease (COPD) and can persist despite comprehensive medical management. It now clear that during physical activity occurs across spectrum of severity, even in those mild airway obstruction. Our understanding nature source incomplete, but current aetiological concepts emphasise importance increased central neural drive to breathe setting a reduced ability respiratory system appropriately respond. Since provoked or aggravated activity, its concurrent measurement standardised laboratory exercise testing clearly important. Combining perceptual physiological responses provide valuable insights into severity pathophysiological underpinnings. This review summarises abnormal COPD, as these form basis for modern constructs neurobiology exertional dyspnoea. The main objectives are: 1) examine role cardiopulmonary (CPET) uncovering mechanisms mild-to-moderate COPD; 2) escalating negative sensory consequences progressive impairment advancement; 3) build rationale individualised treatment optimisation based on CPET.