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Effect of Asthma-Copd Overlap Compared to Copd on Cardiopulmonary Exercise Test Outcomes: Insights from the CanCold Study.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Effect of Asthma-Copd Overlap Compared to Copd on Cardiopulmonary Exercise Test Outcomes: Insights from the CanCold Study./
作者:	Triandafilou, Jaycie.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2023,
面頁冊數:	63 p.
附註:	Source: Masters Abstracts International, Volume: 85-05.
Contained By:	Masters Abstracts International85-05.
標題:	Physiology. -
電子資源:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30718386
ISBN:	9798380705721

Effect of Asthma-Copd Overlap Compared to Copd on Cardiopulmonary Exercise Test Outcomes: Insights from the CanCold Study.
Triandafilou, Jaycie.

Effect of Asthma-Copd Overlap Compared to Copd on Cardiopulmonary Exercise Test Outcomes: Insights from the CanCold Study. - Ann Arbor : ProQuest Dissertations & Theses, 2023 - 63 p.

Source: Masters Abstracts International, Volume: 85-05.

Thesis (M.Sc.)--McGill University (Canada), 2023.

Introduction: Asthma-COPD overlap (ACO) is a chronic lung health condition in which individuals can have clinical features of both asthma and chronic obstructive pulmonary disease (COPD). Even though universally accepted criteria for the diagnosis of ACO do not exist, studies have consistently reported that people with ACO have higher respiratory symptom burden, lower health status, and poorer pulmonary function than people with COPD alone. However, it remains unclear whether these differences in clinical and patient-reported outcomes are associated with greater pathophysiological abnormalities in exercise tolerance and the physiological and/or perceptual response to exercise among people with ACO compared to COPD. Objective: To compare detailed physiological and perceptual responses at the symptom-limited peak of exercise between people with ACO and COPD. Methods: Participants included 411 male or female, ever smokers with a post-bronchodilator forced expiratory volume in 1-sec to forced vital capacity ratio <0.70 who completed pulmonary function tests and a symptom-limited incremental cardiopulmonary cycle exercise test as part of the baseline (cross-sectional) visit of the Canadian Cohort Obstructive Lung Disease (CanCOLD) study - a longitudinal population-based cohort of randomly-sampled Canadian adults aged 40 years. ACO was defined using three clinical definitions: ACO1 (n=103), self-reported presence of respiratory allergies and/or hay fever (atopy); ACO2 (n=125), self-reported physician diagnosed asthma; and ACO3 (n=65), combination of self-reported atopy and physician diagnosed asthma. Participants were identified as having COPD (no-ACO) when they did not self-report atopy and/or physician diagnosed asthma (n=248). Results: Compared to people with COPD alone, people with ACO (largely independent of the clinical definition used) had significantly lower respiratory-related health status (i.e., higher St. George's Respiratory Questionnaire and COPD Assessment Test total scores), higher respiratory symptom burden (i.e., more frequent reports of chronic cough, phlegm, wheeze, and bronchitis; and Medical Research Council dyspnea scale ratings), worse baseline pulmonary function (i.e., lower % predicted FEV1), greater bronchodilator reversibility, and greater use of respiratory medication(s), especially inhaled corticosteroids alone or in combination with a long-acting bronchodilator. Nevertheless, people with ACO (regardless of how it was defined) had remarkably similar physiological responses to symptom-limited incremental cycle CPET without evidence of greater pathophysiological abnormalities in peak exercise capacity (i.e., peak rate of O2 consumption and power output) compared to people with COPD. Conclusion:Despite presenting with significantly worse clinical and patient-reported health outcomes, people with ACO had similarly impaired exercise tolerance without evidence of greater abnormalities in the cardiometabolic, ventilation, breathing pattern, gas exchange and dynamic breathing mechanic responses to exercise.

ISBN: 9798380705721Subjects--Topical Terms:

518431
Physiology.

Effect of Asthma-Copd Overlap Compared to Copd on Cardiopulmonary Exercise Test Outcomes: Insights from the CanCold Study.
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520 $a Introduction: Asthma-COPD overlap (ACO) is a chronic lung health condition in which individuals can have clinical features of both asthma and chronic obstructive pulmonary disease (COPD). Even though universally accepted criteria for the diagnosis of ACO do not exist, studies have consistently reported that people with ACO have higher respiratory symptom burden, lower health status, and poorer pulmonary function than people with COPD alone. However, it remains unclear whether these differences in clinical and patient-reported outcomes are associated with greater pathophysiological abnormalities in exercise tolerance and the physiological and/or perceptual response to exercise among people with ACO compared to COPD. Objective: To compare detailed physiological and perceptual responses at the symptom-limited peak of exercise between people with ACO and COPD. Methods: Participants included 411 male or female, ever smokers with a post-bronchodilator forced expiratory volume in 1-sec to forced vital capacity ratio <0.70 who completed pulmonary function tests and a symptom-limited incremental cardiopulmonary cycle exercise test as part of the baseline (cross-sectional) visit of the Canadian Cohort Obstructive Lung Disease (CanCOLD) study - a longitudinal population-based cohort of randomly-sampled Canadian adults aged 40 years. ACO was defined using three clinical definitions: ACO1 (n=103), self-reported presence of respiratory allergies and/or hay fever (atopy); ACO2 (n=125), self-reported physician diagnosed asthma; and ACO3 (n=65), combination of self-reported atopy and physician diagnosed asthma. Participants were identified as having COPD (no-ACO) when they did not self-report atopy and/or physician diagnosed asthma (n=248). Results: Compared to people with COPD alone, people with ACO (largely independent of the clinical definition used) had significantly lower respiratory-related health status (i.e., higher St. George's Respiratory Questionnaire and COPD Assessment Test total scores), higher respiratory symptom burden (i.e., more frequent reports of chronic cough, phlegm, wheeze, and bronchitis; and Medical Research Council dyspnea scale ratings), worse baseline pulmonary function (i.e., lower % predicted FEV1), greater bronchodilator reversibility, and greater use of respiratory medication(s), especially inhaled corticosteroids alone or in combination with a long-acting bronchodilator. Nevertheless, people with ACO (regardless of how it was defined) had remarkably similar physiological responses to symptom-limited incremental cycle CPET without evidence of greater pathophysiological abnormalities in peak exercise capacity (i.e., peak rate of O2 consumption and power output) compared to people with COPD. Conclusion:Despite presenting with significantly worse clinical and patient-reported health outcomes, people with ACO had similarly impaired exercise tolerance without evidence of greater abnormalities in the cardiometabolic, ventilation, breathing pattern, gas exchange and dynamic breathing mechanic responses to exercise.
520 $a Introduction: Le chevauchement entre l'asthme et la BPCO (ACO) est un probleme de sante pulmonaire chronique dans lequel les individus peuvent presenter des caracteristiques cliniques a la fois d'asthme et de bronchopneumopathie chronique obstructive (BPCO). Bien qu'il n'existe pas de criteres universellement acceptes pour le diagnostic du chevauchement de l'asthme et de la BPCO, des etudes ont regulierement rapporte que les personnes souffrant de chevauchement de l'asthme et de la BPCO presentent une charge de symptomes respiratoires plus importante, un etat de sante moins bon et une fonction pulmonaire moins bonne que les personnes souffrant uniquement de BPCO. Cependant, on ne sait toujours pas si ces differences dans les resultats cliniques et les resultats rapportes par les patients sont associees a des anomalies physiopathologiques plus importantes dans la tolerance a l'exercice et la reponse physiologique et/ou perceptive a l'exercice chez les personnes atteintes d'ACO par rapport aux personnes atteintes de BPCO. Objectif: Comparer les reponses physiologiques et perceptives detaillees au pic d'exercice limite par les symptomes chez les personnes atteintes de BCA et de BPCO. Methodes:Les participants comprenaient 411 hommes ou femmes, fumeurs inveteres, avec un volume expiratoire force en 1 seconde post-bronchodilatateur par rapport a la capacite vitale forcee <0,70, qui ont effectue des tests de fonction pulmonaire et un test d'exercice cardio-pulmonaire incremental limite par les symptomes dans le cadre de la visite de base (transversale) de l'etude Canadian Cohort Obstructive Lung Disease (CanCOLD) - une cohorte longitudinale basee sur la population d'adultes canadiens ages de 40 ans echantillonnes au hasard. Le BCA a ete defini a l'aide de trois definitions cliniques : ACO1 (n=103), presence autodeclaree d'allergies respiratoires et/ou de rhume des foins (atopie) ; ACO2 (n=125), asthme autodeclare diagnostique par un medecin ; et ACO3 (n=65), combinaison d'atopie autodeclaree et d'asthme diagnostique par un medecin. Les participants ont ete identifies comme ayant une BPCO (no-ACO) lorsqu'ils ne declaraient pas d'atopie et/ou d'asthme diagnostique par un medecin (n=248).Resultats:Comparativement aux personnes souffrant uniquement de BPCO, les personnes souffrant d'ACO (en grande partie independamment de la definition clinique utilisee) presentaient un etat de sante respiratoire significativement plus faible (c.-a-d. des scores totaux plus eleves au Questionnaire respiratoire de St-Georges et au Test d'evaluation de la BPCO), une charge de symptomes respiratoires plus elevee (c.-a-d. des rapports plus frequents de toux chronique, d'asthme et d'autres symptomes), rapports plus frequents de toux chronique, d'expectoration, de respiration sifflante et de bronchite ; et evaluations de l'echelle de dyspnee du Medical Research Council), fonction pulmonaire de base moins bonne (c.-a-d. % inferieur de VEMS predit), reversibilite plus grande des bronchodilatateurs et utilisation plus importante de medicaments respiratoires, en particulier de corticosteroides inhales seuls ou en association avec un bronchodilatateur a action prolongee. Neanmoins, les personnes atteintes d'ACO (quelle que soit la facon dont elles ont ete definies) presentaient des reponses physiologiques remarquablement similaires a l'EEPC incrementielle limitee par les symptomes, sans preuve d'anomalies physiopathologiques plus importantes dans la capacite d'exercice maximale (c'est-a-dire le taux maximal de consommation d'oxygene et la puissance de sortie) par rapport aux personnes atteintes de BPCO.
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