Pulmonary Physiology |

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

Vanessa Yap, MD; Aaron Glucksman, MD; Antranik Mangardich, MD; Debapriya Datta, MD
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University of CT Health Center, Farmington, CT

Chest. 2015;148(4_MeetingAbstracts):900A. doi:10.1378/chest.2269304
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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 existing studies seem to indicate that cardiac, pulmonary, vascular, and muscle performance does not differ between obese and normal subjects. The objective of this study was to determine whether physiological responses during CPExT differ in obese and non-obese subjects with exertional dyspnea.

METHODS: Records of patients who underwent CPExT for evaluation of unexplained dyspnea in our institution over the last 5 years were reviewed. Parameters obtained included: age, gender, body mass index (BMI), Anaerobic threshold (AT), O2 pulse, maximal O2uptake (VO2max), Heart rate reserve (HRR), maximal voluntary ventilation (MVV), maximal minute ventilation (VEmax), Breathing reserve (VR), dead space (Vd/Vt) at rest and exercise. The studied parameters were compared in obese patients (BMI >30) and non-obese patients (BMI < 30). Univariate analysis by independent t-test was performed to assess difference in physiological parameters between the two groups; p <0.05 was statistically significant.

RESULTS: Of 163 patients, 65% were females; mean age was 53.5+ 16 years. 77 patients (48%) were obese with BMI> 30. The studied parameters in the obese and non-obese patients are tabulated below. Parameter ---------------------→ Obese versus Non-obese VO2max (ml/kg/min)----------→15 ± 6 versus. 20.5 ± 7 (p<0.001) AT (L/min)------------------------→1.1 ± 0.4 versus1.14 ± 0.5 (p=0.96) O2 pulse % pred--------------→ 105 ± 25 versus 89 ± 22 (p=0.003) MaxHR(beats/min)-----------→ 124 ± 23 versus 136 ± 26 (p=0.003) HRR(beats/min)---------------→ 31.5 ± 33 versus. 12 ± 46 (p=0.003) VEmax (L/min)-----------------→ 55 ± 19 versus 59 ± 25 (p=0.2) MVV (% pred)------------------→ 75± 21 versus 80 ± 21 (p=0.2) BR(%)-----------------------------→ 32 ± 24 versus 37 ± 20 (p=0.2) Vd/Vt (Rest)---------------------→ 0.3 ± 0.08 vs. 0.3 ± 0.08 (p=0.7) Vd/Vt (Exercise)---------------→ 0.16 ± 0.05 vs. 0.17 ± 0.05 (p=0.8)

CONCLUSIONS: Obese subjects have reduced exercise capacity, higher O2pulse and achieve a lower MaxHR with a higher HRR compared to non-obese. Obesity does not significantly affect ventilatory, muscle and gas exchange parameters during exercise.

CLINICAL IMPLICATIONS: CPExT can accurately assess pulmonary, muscular and gas exchange parameters during exercise in obese patients with exertional dyspnea, but may not accurately assess cardiac limitation to exercise due to inability to achieve MaxHR.

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

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