Abstract
Objectives
This study tested the hypothesis that sarcopenia, a common extrapulmonary feature
of chronic obstructive pulmonary disease (COPD), can affect ventilatory behavior,
and worsen the multidimensional nature of dyspnea in patients with COPD.
Design
Cross-sectional survey study.
Setting
and Participants: Stable outpatients with COPD encountered in general practice and
respiratory clinic.
Method
Sarcopenia was diagnosed according to an appendicular skeletal muscle mass index based
on measurements of electrical impedance and handgrip strength. Exertional dyspnea
was tested using a 3-minute Step Test and a 6-minute Walk Test. The dimensions of
dyspnea were assessed by a multidimensional dyspnea profile.
Results
Of 60 stable patients with COPD, 16 met the criteria for sarcopenia. During the 3-minute
Step Test, minute ventilation as a proportion of exercise time, tidal volume as a
proportion of inspiratory capacity, the change in inspiratory capacity, and ventilation
as a proportion of maximal voluntary ventilation did not differ between patients with
and without sarcopenia. Patients with sarcopenia exhibited lower evolution of tidal
volume, higher evolution of respiratory frequency versus ventilation and breathing
discomfort on the 3-minute Step Test, as well as increased physical breathing effort
on the 6-minute Walk Test, compared with those without sarcopenia. In a multivariable
model adjusted using inverse probability weighting, sarcopenia was independently associated
with breathing discomfort during the 3-minute Step Test and physical breathing effort
during the 6-minute Walk Test.
Conclusions and Implications
Sarcopenia may be associated with shallow breathing and diverse sensory and affective
components of exertional dyspnea in patients with COPD. The study indicates that improvement
of the rapid breathing pattern may offer unique ways to alleviate dyspnea in older
patients with COPD and sarcopenia.
Keywords
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Article info
Publication history
Published online: March 02, 2021
Footnotes
Naoya Tanabe and Susumu Sato report grants from FUJIFILM Co., Ltd., outside this work.
This study was supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology (18K17741), Research Grants from the Osaka Gas Group Welfare Foundation (H28 and H29), and a Research Grant from the Furukawa Medical & Welfare Foundation (H31).
Identification
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© 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
