Impact of pulmonary emphysema on exercise capacity and its physiological determinants in chronic obstructive pulmonary disease

Abstract

Exercise limitation is common in chronic obstructive pulmonary disease (COPD). We determined the impact of pulmonary emphysema on the physiological response to exercise independent of contemporary measures of COPD severity. Smokers 40–79 years old with COPD underwent computed tomography, pulmonary function tesing, and symptom-limited incremental exercise testing. COPD severity was quantified according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) by spirometry (GOLD 1–4); and symptom burden and exacerbation risk (GOLD A-D). Emphysema severity was quantified as the percent lung volume