Sex- and age-adjusted reference values for dynamic inspiratory constraints during incremental cycle ergometry

Area of Science:

• Pulmonary Physiology
• Exercise Medicine

Background:

• Activity-related dyspnea in chronic lung disease is linked to dynamic inspiratory constraints.
• Limited reference values for exertional inspiratory reserve (IR) hinder cardiopulmonary exercise testing (CPET) for dyspnea evaluation.

Purpose of the Study:

• To establish centile-based reference values for dynamic inspiratory reserve (IRdyn) during exercise.
• To assess the relationship between IRdyn metrics and exertional dyspnea.

Main Methods:

• 150 healthy adults (40-85 years) underwent incremental cycle ergometry.
• Dynamic inspiratory reserve metrics (IRdyn1, IRdyn2) were calculated based on exercise inspiratory capacity (ICdyn).
• Sex and age-specific reference values were generated as a function of ventilation.

Main Results:

• IRdyn1 and IRdyn2 reference values were lower in females and older subjects.
• Lower IRdyn1 and IRdyn2 significantly predicted the severity of exertional dyspnea in both sexes.
• Sex- and age-adjusted limits of reference were established.

Conclusions:

• Novel sex- and age-adjusted reference values for dynamic inspiratory reserve improve CPET interpretation.
• These metrics aid clinicians in identifying and quantifying abnormally low inspiratory reserves in dyspneic patients.