Impact of Integrative Cardiopulmonary Exercise Testing (23)
Recently, pulmonary vasodilators have been administered to patients with COPD with the consideration that the pulmonary circulation limits exercise. In one study, for example, hydralazine reduced pulmonary hypertension, but there was no improvement in symptom-limited maximum 02 uptake. Similar findings were reported by Adnot et al for the pharmacologic vasodilator, urapidil. These studies emphasize the need to separate hemodynamic improvement from improvement in exercise capacity. Finally, various methods of rehabilitation of patients with COPD would ideally be evaluated by their success in improving exercise capacity.
In summary, there is considerable interest in integrative cardiopulmonary exercise testing in the evaluation of patients with COPD. It is likely that future studies will focus on defining groups of patients with COPD with ventilatory limitation or cardiovascular limitation to tailor therapy and rehabilitation strategies. In addition, treatment directed at improving ventilatory mechanics, reducing respiratory muscle fatigue, and ameliorating dyspnea will be evaluated using integrative cardiopulmonary exercise testing. ventolin 100 mcg
Interstitial lung diseases: Resting pulmonary function tests may not be predictive of exercise capacity in interstitial lung disease. Bye et al reported the cases of 16 patients with interstitial lung disease of several causes, mostly idiopathic pulmonary fibrosis or pneumoconiosis, of whom only three had either a vital capacity of less than 50 percent and/or Deo of less than 40 percent of predicted value.