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Respiratory Muscles and Dyspnea in Obese Nonsmoking Subjects

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Abstract

To our knowledge no data have been reported on the contribution to acute increase in dyspnea by the respiratory muscles in obese nonsmoking subjects. To better focus on this topic, we studied seven obese subjects and an age-matched normal control group, assessing baseline pulmonary function, breathing pattern, esophageal pressure (Pes), and gastric (Pga) and transdiaphragmatic (Pdi) pressures. Pes was also recorded during a sniff maneuver (Pessn). During a hypercapnic rebreathing test we recorded inspiratory swing in Pes (Pessw), expiratory changes in Pga, and inspiratory swings in Pdi (Pdisw). Change in inspiratory capacity was considered the mirror image of end-expiratory lung volume (EELV). Dyspnea was assessed by a modified Borg scale. Under control conditions, patients exhibited a reduced expiratory reserve volume and intrinsic positive end-expiratory pressure (PEEPi). At the end of hypercapnic stimulation, compared with controls our obese subjects exhibited greater respiratory frequency (Rf), shorter expiratory time, greater Pessw, and lower Pdisw. Increases in EELV and PEEPi were found in the obese subjects but not in controls. Changes in Borg correlated with changes in PETCO2, VE, Pessw (%Pessn), and Pdisw to a greater extent in patients than in controls. Stepwise regression analysis indicated the amount of variability in Borg that was predicted by both Pdisw (r2 = 0.31, p < 0.0004), and Pessw (%Pessn) (r2 = 0.09, p < 0.005) in controls, and by Pessw (%Pessn) (r2 = 0.40, p <0.00001) in obese subjects. We conclude that the rib cage muscles contributed to dyspnea to a greater extent in this subset of obese subjects.

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Authors and Affiliations

  1. Department of Internal Medicine, Section of Clinical Immunology, Allergology and Respiratory Diseases, University of Florence, Viale G.B. Morgagni 85, Firenze, 50134, Italy

    Pamela Lotti, Roberto Duranti & Giorgio Scano

  2. Fondazione Don C. Gnocchi IRCCS, Respiratory Rehabilitation Unit, Via Imprunetana 124, Pozzolatico, Firenze, 50020, Italy

    Francesco Gigliotti, Loredana Stendardi, Michela Grazzini & Giorgio Scano

  3. Department of Clinical Physiopathology, Unit of Endocrinology, Section of Metabolic Diseases, University of Florence, Viale Pieraccini 6, Firenze, 50139, Italy

    Federica Tesi

Authors
  1. Pamela Lotti
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  2. Francesco Gigliotti
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  3. Federica Tesi
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  4. Loredana Stendardi
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  5. Michela Grazzini
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  6. Roberto Duranti
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  7. Giorgio Scano
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Correspondence to Giorgio Scano.

Additional information

This work was supported by grants of the Università degli Studi di Firenze.

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Lotti, P., Gigliotti, F., Tesi, F. et al. Respiratory Muscles and Dyspnea in Obese Nonsmoking Subjects. Lung 183, 311–323 (2005). https://doi.org/10.1007/s00408-005-2544-5

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  • DOI: https://doi.org/10.1007/s00408-005-2544-5

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