Muscle strength as a determinant of oxygen uptake efficiency and maximal metabolic response in patients with mild-to-moderate COPD

J Bras Pneumol. 2012 Sep-Oct;38(5):541-9. doi: 10.1590/s1806-37132012000500002.
[Article in English, Portuguese]

Abstract

Objective: To compare the behavior of the oxygen uptake efficiency slope (OUES) with that of oxygen uptake at peak exertion (VO₂peak).

Methods: This was a prospective cross-sectional study involving 21 patients (15 men) with mild-to-moderate COPD undergoing spirometry, handgrip strength (HGS) testing, cardiopulmonary exercise testing, and determination of lactate at peak exertion (LACpeak).

Results: Mean weight was 66.7 ± 13.6 kg, and mean age was 60.7 ± 7.8 years. With the exception of FEV₁ and FEV1/FVC ratio (75.8 ± 18.6 of predicted and 56.6 ± 8.8, respectively), all spirometric variables were normal, as was HGS. The patients exhibited significant metabolic and hemodynamic stress, as evidenced by the means (% of predicted) for VO₂peak (93.1 ± 15.4), maximum HR (92.5 ± 10.4), and OUES (99.4 ± 24.4), as well as for the gas exchange rate (1.2 ± 0.1). The correlation between VO₂peak and OUES was significant (r = 0.747; p < 0.0001). The correlation between HGS and VO₂peak (r = 0.734; p < 0.0001) was more significant than was that between HGS and OUES (r = 0.453; p < 0.05). Similar results were found regarding the correlations of VO₂peak and OUES with MIP. Although LACpeak correlated significantly with VO₂peak (r = -0.731; p < 0.0001), only LACpeak/maximum power correlated significantly with OUES (r = -0.605; p = 0.004).

Conclusions: Our findings suggest that, in mild-to-moderate COPD, VO2 determinants other than overall muscle strength have a greater impact on OUES than on VO₂peak.

Publication types

  • Comparative Study

MeSH terms

  • Cross-Sectional Studies
  • Exercise Test
  • Exercise Tolerance / physiology
  • Female
  • Humans
  • Lactic Acid / metabolism
  • Male
  • Middle Aged
  • Muscle Strength / physiology*
  • Oxygen Consumption / physiology*
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive / metabolism
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Pulmonary Ventilation / physiology*
  • Respiratory Function Tests
  • Respiratory Muscles / physiology*
  • Severity of Illness Index

Substances

  • Lactic Acid