High Tail Hall 2 Game Rip [HOT]
High Tail Hall 2 Game Rip
20 IMAGES EditBreathlessness is the main presenting symptom of a patient with chronic obstructive pulmonary disease (COPD) who is being assessed for the potential of lung volume reduction surgery. We have shown previously in normal subjects that breathlessness is a complex and variable sensation mediated by central respiratory and non-respiratory pathways and that it is a useful tool for describing the magnitude of a chosen lower airway obstruction during exercise. Accordingly, we propose to apply these novel methods in assessing breathlessness during exercise in patients with COPD undergoing clinically indicated lung volume reduction surgery as a means of predicting exercise performance after surgery. We will assess breathlessness at rest and during exercise on the day of lung volume reduction surgery, and at a follow-up 6-week post-operative visit. We predict that pre-operative COPD breathlessness will be quantified by magnitude of the COPD functional index, a novel descriptor of COPD breathlessness. During exercise, we predict that when the pre-operative COPD breathlessness is equal to or greater than the COPD functional index, peak exercise breathlessness and endurance will be reduced after lung volume reduction surgery, and that when the COPD breathlessness during exercise is less than the functional index, breathlessness and endurance will be substantially improved after lung volume reduction surgery. We will also determine whether post-operative COPD breathlessness during exercise will correlate with post-operative exercise performance. This study will assess how pre-operative breathlessness during exercise and the magnitude of COPD airway obstruction at rest relate to the predicted benefits of surgery. It will validate a novel descriptor of breathlessness during exercise as a descriptor of COPD breathlessness and exercise performance and also provide insight on the changes in dyspnea during exercise after lung volume reduction surgery in patients with COPD. PUBLIC HEALTH RELEVANCE: Chronic obstructive pulmonary disease (COPD) is a major source of mortality worldwide, but its disease-related mortality can be reduced by early assessment and treatment. The resulting impact of this disease is not only a major social, financial, and emotional burden to both patients and their families, but also a medical challenge for health care professionals. The breathlessness at rest and during exercise (an important symptom of COPD) is related to the extent of disease in patients with COPD, and also provides an objective measure of the severity of the disease. This study will assess how much breathlessness is present in patients with COPD at rest and during exercise, and how much this changes after lung volume reduction surgery.
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