Effects of Sarcopenia on Ventilatory Behavior and the Multidimensional Nature of Dyspnea in Patients With Chronic Obstructive Pulmonary Disease

Objectives: This study tested the hypothesis that sarcopenia, a common extrapulmonary feature of chronic obstructive pulmonary disease (COPD), can affect ventilatory behavior, and worsen the multi-dimensional nature of dyspnea in patients with COPD. Design: Cross-sectional survey study. Setting: and Participants: Stable outpatients with COPD encountered in general practice and respiratory clinic. Method: Sarcopenia was diagnosed according to an appendicular skeletal muscle mass index based on measurements of electrical impedance and handgrip strength. Exertional dyspnea was tested using a 3 -minute Step Test and a 6-minute Walk Test. The dimensions of dyspnea were assessed by a multidi-mensional dyspnea profile. Results: Of 60 stable patients with COPD, 16 met the criteria for sarcopenia. During the 3-minute Step Test, minute ventilation as a proportion of exercise time, tidal volume as a proportion of inspiratory capacity, the change in inspiratory capacity, and ventilation as a proportion of maximal voluntary ventilation did not differ between patients with and without sarcopenia. Patients with sarcopenia exhibited lower evolution of tidal volume, higher evolution of respiratory frequency versus ventilation and breathing discomfort on the 3-minute Step Test, as well as increased physical breathing effort on the 6-minute Walk Test, compared with those without sarcopenia. In a multivariable model adjusted using inverse probability weighting, sarcopenia was independently associated with breathing discomfort during the 3-minute Step Test and physical breathing effort during the 6-minute Walk Test. Conclusions and Implications: Sarcopenia may be associated with shallow breathing and diverse sensory and affective components of exertional dyspnea in patients with COPD. The study indicates that improvement of the rapid breathing pattern may offer unique ways to alleviate dyspnea in older patients with COPD and sarcopenia. (c) 2021 AMDA -The Society for Post-Acute and Long-Term Care Medicine.

Automated summary

This study investigated the impact of sarcopenia on ventilatory behavior and dyspnea in patients with COPD. The results showed that sarcopenia was associated with shallow breathing and various sensory and affective components of exertional dyspnea. Improved breathing patterns could potentially alleviate dyspnea in older COPD patients with sarcopenia.