Stress plays a role in causing exertional dyspnea in patients with non-severe chronic obstructive pulmonary disease (COPD), according to a study published in Arquivos Brasileiros de Cardiologia.

Exertional dyspnea, the researchers wrote, “is a common complaint of patients with heart failure with preserved ejection fraction (HFpEF) and COPD. HFpEF is common in COPD and is an independent risk factor for disease progression and exacerbation. Early detection, therefore, has great clinical relevance.”

In this study, researchers applied cardiopulmonary exercise testing (CPET) parameters to assess 104 patients with non-severe COPD with exertional dyspnea who did not have cardiovascular disease (CVD). All patients underwent echocardiography before and at peak CPET. The researchers noted that cutoff values for stress-induced left and right ventricular diastolic dysfunction (LVDD/ RVDD) were E/e’>15 and E/e’>6, respectively.

According to the results, 64% of patients had stress-induced LVDD, and 78% had stress-induced RVDD. Both study groups with stress LVDD and RVDD achieved lower load, lower V’O2 and O2-pulse, the researchers further noted.

“There is a high prevalence of stress-induced diastolic dysfunction in [patients with] non-severe COPD with exertional dyspnea, free of overt CVD,” the researchers concluded. “None of the CPET parameters correlates to stress-induced E/e’. This demands the performance of exercise stress echocardiography and CPET for the early detection and proper management of masked HFpEF in this population.”

Keywords: dyspnea, heart failure, COPD