Pelgröm A T, de Jongh F H C, van den Aardweg J G, van Veen I H P A A
Department of Respiratory Medicine, Amsterdam University Medical Center, Location, VUMC, Amsterdam, the Netherlands; Department of Respiratory Medicine, Medisch Spectrum Twente, Enschede, the Netherlands; Amsterdam Movements Sciences, Sports, Amsterdam, the Netherlands.
Department of Respiratory Medicine, Medisch Spectrum Twente, Enschede, the Netherlands.
Respir Med. 2025 Apr-May;240:108037. doi: 10.1016/j.rmed.2025.108037. Epub 2025 Mar 11.
About 25 % of patients with asthma suffer from dysfunctional breathing, often leading to exercise induced dyspnoea (EID). EID, however, is often attributed to exercise induced bronchoconstriction, while the contribution of dysfunctional breathing to EID is overlooked. This leads to potential suboptimal treatment of patients with asthma. Therefore, this study investigates the breathing patterns of patients with asthma during exercise compared to healthy subjects and its influence on the level of EID.
This cross-sectional study investigated individual breathing patterns of 15 well-controlled asthma patients and 15 healthy subjects during a cardiopulmonary exercise test (CPET), objectified with a newly designed parameter Breathing Pattern (BP) angle. This parameter describes the gradual relation between the increase in tidal volume and breathing frequency in the middle phase of CPET (40-60 % of max load reached) corrected for forced vital capacity. Dyspnoea was assessed with VAS and Borg scores.
BP angle and other CPET parameters were similar among groups. In both groups, 3 subjects had a BP angle<45° (n = 6), indicating relative fast shallow breathing during mid-level exercise. They experienced a significantly higher level of dyspnoea at max exercise compared to subjects with BP angle>45° (n = 24) (VAS: 86.5 vs 65.5 mm (p = 0.036), Borg: 8 vs 4 (p = 0.001)).
An increase of breathing frequency at mid-level exercise, quantified with BP angle, is related to higher levels of dyspnoea. This indicates that dysfunctional breathing patterns play an important role in the development of exercise induced dyspnoea in patients with asthma and require more attention regarding treatment.
约25%的哮喘患者存在呼吸功能异常，常导致运动诱发的呼吸困难（EID）。然而，EID通常被归因于运动诱发的支气管收缩，而呼吸功能异常对EID的影响却被忽视。这可能导致哮喘患者的治疗效果欠佳。因此，本研究调查了哮喘患者与健康受试者在运动期间的呼吸模式及其对EID水平的影响。
这项横断面研究在心肺运动试验（CPET）期间调查了15名病情得到良好控制的哮喘患者和15名健康受试者的个体呼吸模式，并用新设计的参数呼吸模式（BP）角进行客观评估。该参数描述了在CPET中期（达到最大负荷的40%-60%）潮气量增加与呼吸频率之间的渐进关系，并根据用力肺活量进行校正。使用视觉模拟评分法（VAS）和博格评分评估呼吸困难程度。
两组之间的BP角和其他CPET参数相似。在两组中，均有3名受试者的BP角<45°（n = 6），表明在中等强度运动期间呼吸相对快而浅。与BP角>45°的受试者（n = 24）相比，他们在最大运动时的呼吸困难程度明显更高（VAS：86.5 vs 65.5 mm（p = 0.036），博格评分：8 vs 4（p = 0.001））。
用BP角量化的中等强度运动时呼吸频率增加与更高程度的呼吸困难有关。这表明呼吸功能异常模式在哮喘患者运动诱发呼吸困难的发生中起重要作用，在治疗方面需要更多关注。
