Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
These four authors are co-authors.
Eur Respir J. 2022 Aug 4;60(2). doi: 10.1183/13993003.01821-2021. Print 2022 Aug.
Cardiorespiratory fitness is not limited by pulmonary mechanical reasons in the majority of adults. However, the degree to which lung function contributes to exercise response patterns among ostensibly healthy individuals remains unclear.
We examined 2314 Framingham Heart Study participants who underwent cardiopulmonary exercise testing (CPET) and pulmonary function testing. We investigated the association of forced expiratory volume in 1 s (FEV), forced vital capacity (FVC), FEV/FVC and diffusing capacity of the lung for carbon monoxide ( ) with the primary outcome of peak oxygen uptake (' ) along with other CPET parameters using multivariable linear regression. Finally, we investigated the association of total and peripheral pulmonary blood vessel volume with peak ' .
We found lower FEV, FVC and were associated with lower peak ' . For example, a 1 L lower FEV and FVC was associated with a 7.1% (95% CI 5.1-9.1%) and 6.0% (95% CI 4.3-7.7%) lower peak ' , respectively. By contrast, FEV/FVC was not associated with peak ' . Lower lung function was associated with lower oxygen uptake efficiency slope, oxygen pulse slope, ' at anaerobic threshold (AT), minute ventilation (') at AT and breathing reserve. In addition, lower total and peripheral pulmonary blood vessel volume were associated with lower peak ' .
In a large, community-based cohort of adults, we found lower FEV, FVC and were associated with lower exercise capacity, as well as oxygen uptake efficiency slope and ventilatory efficiency. In addition, lower total and peripheral pulmonary blood vessel volume were associated with lower peak ' . These findings underscore the importance of lung function and blood vessel volume as contributors to overall exercise capacity.
在大多数成年人中，心肺适能不受肺部力学原因的限制。然而，肺功能在多大程度上影响看似健康个体的运动反应模式仍不清楚。
我们检查了 2314 名接受心肺运动测试（CPET）和肺功能测试的弗雷明汉心脏研究参与者。我们使用多变量线性回归研究了 1 秒用力呼气量（FEV）、用力肺活量（FVC）、FEV/FVC 和一氧化碳弥散量（）与主要结局（峰值摄氧量（））以及其他 CPET 参数之间的关系。最后，我们研究了总肺和外周肺血管容积与峰值的关系。
我们发现较低的 FEV、FVC 和较低的峰值。例如，FEV 和 FVC 每降低 1L，峰值分别降低 7.1%（95%可信区间 5.1-9.1%）和 6.0%（95%可信区间 4.3-7.7%）。相比之下，FEV/FVC 与峰值无关。较低的肺功能与较低的氧摄取效率斜率、氧脉冲斜率、无氧阈（AT）时的峰值、AT 时的分钟通气量（）和呼吸储备有关。此外，较低的总肺和外周肺血管容积与较低的峰值有关。
在一项大型、基于社区的成年人队列中，我们发现较低的 FEV、FVC 和较低的运动能力以及氧摄取效率斜率和通气效率有关。此外，较低的总肺和外周肺血管容积与较低的峰值有关。这些发现强调了肺功能和血管容积作为整体运动能力的贡献者的重要性。
