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Pulmonary Physiology |

Exercise Performance in Obese and Nonobese Subjects With Exertional Dyspnea During Cardiopulmonary Exercise Testing FREE TO VIEW

Aaron Glucksman, MD; Vanessa Yap, MD; Nancy McLellan, RRT; Debapriya Datta, MD
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University of CT Health Ctr, Farmington, CT, Farmington, CT


Chest. 2015;148(4_MeetingAbstracts):903A. doi:10.1378/chest.2225038
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Abstract

SESSION TITLE: Pulmonary Physiology Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Limited studies exist on work capacity and cardiopulmonary responses of the obese subject during exercise testing. Decreased peak work rates are usually seen among obese subjects. The objective of this study is to determine whether obesity affects work performance during cardiopulmonary exercise testing (CPExT) for evaluation of exertional dyspnea.

METHODS: Records of 163 patients who underwent CPExT for evaluation of unexplained dyspnea in our institution over the last 5 years were reviewed. The following parameters were obtained: age, gender, body mass index (BMI), maximum predicted heart rate reached (%MaxHR), total work in watts; percent of maximum predicted work (%MaxWR) achieved, oxygen uptake (VO2)/work slope, and respiratory quotient (RQ). Number of patients undergoing CPExT, in whom an etiology of dyspnea could/could not be established, were noted. Studied parameters were compared in obese (BMI >30) and non-obese (BMI < 30) patients by univariate analysis, using indepedent t-test. p <0.05 was deemed statistically significant.

RESULTS: Of 163 patients, 65% were females; mean age was 53.5+ 16 years. 72 patients (44%) were obese with BMI> 30. The studied parameters in the obese and non-obese patients are shown below: Parameter-- -------------→ Obese vs. Non-obese %MaxHR ------------------→0.77 ± 0.12 vs. 0.8 ± 0.11 (p=0.001) Total work (watts) -------→101 ± 42 vs. 115 ± 57 (p=0.07) %MaxWR--------------------→0.72 ± 0.2 vs.0.78 ± 0.2 (p=0.18) VO2/work ---------------------→10 ± 3.7 vs. 9 ± 2.4 (p=0.03) RQ -------------------------------→1.05 ± 0.11 vs.1.1 ± 0.1 (p=0.003) Diagnosis of dyspnea-----→ 63 percent vs. 74percent (p=0.131)

CONCLUSIONS: CPExTs in obese subjects were submaximal, as indicated by lower %MaxHR, total work and RQ during CPExT though %MaxWR was not significantly different.VO2/WR, though normal, was lower in non-obese subjects.

CLINICAL IMPLICATIONS: Despite submaximal tests, obesity doesnot affect diagnostic yield in CPExT. The significance of lower VO2/WR in non-obese subjects is not clear and merits further study.

DISCLOSURE: The following authors have nothing to disclose: Aaron Glucksman, Vanessa Yap, Nancy McLellan, Debapriya Datta

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