{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:11:37Z","timestamp":1790629897841,"version":"4.1.0"},"reference-count":42,"publisher":"European Respiratory Society (ERS)","issue":"3","funder":[{"name":"Ontario Thoracic Society"},{"name":"Canadian Institutes of Health Research"},{"name":"William Spear\/Richard Start Endowment Fund, Queen's University, Canada"},{"name":"Canadian Lung Association (CLA)\/Canadian Thoracic Society"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2016,5,16]]},"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:p>Dyspnoea and activity limitation can occur in smokers who do not meet spirometric criteria for chronic obstructive pulmonary disease (COPD) but the underlying mechanisms are unknown.<\/jats:p>\n                  <jats:p>\n                    Detailed pulmonary function tests and sensory\u2013mechanical relationships during incremental exercise with respiratory pressure measurements and diaphragmatic electromyography (EMG\n                    <jats:sub>di<\/jats:sub>\n                    ) were compared in 20 smokers without spirometric COPD and 20 age-matched healthy controls.\n                  <\/jats:p>\n                  <jats:p>\n                    Smokers (mean\u00b1\n                    <jats:sc>sd<\/jats:sc>\n                    post-bronchodilator forced expiratory volume in 1\u2005s (FEV\n                    <jats:sub>1<\/jats:sub>\n                    )\/forced vital capacity 75\u00b14%, mean\u00b1\n                    <jats:sc>sd<\/jats:sc>\n                    FEV\n                    <jats:sub>1<\/jats:sub>\n                    104\u00b114% predicted) had greater activity-related dyspnoea, poorer health status and lower physical activity than controls. Smokers had peripheral airway dysfunction: higher phase-III nitrogen slopes (3.8\u00b11.8\n                    <jats:italic>versus<\/jats:italic>\n                    2.6\u00b11.1%\u00b7L\n                    <jats:sup>\u22121<\/jats:sup>\n                    ) and airway resistance (difference between airway resistance measured at 5\u2005Hz and 20\u2005Hz 19\u00b111\n                    <jats:italic>versus<\/jats:italic>\n                    12\u00b17% at 5\u2005Hz) than controls (p&lt;0.05). Smokers had significantly (p&lt;0.05) lower peak oxygen uptake (78\u00b140\n                    <jats:italic>versus<\/jats:italic>\n                    107\u00b145% predicted) and ventilation (61\u00b126\n                    <jats:italic>versus<\/jats:italic>\n                    97\u00b129\u2005L\u00b7min\n                    <jats:sup>\u22121<\/jats:sup>\n                    ). Exercise ventilatory requirements, operating lung volumes and cardio-circulatory responses were similar. However, submaximal dyspnoea ratings, resistive and total work of breathing were increased in smokers compared with controls (p&lt;0.05); diaphragmatic effort (transdiaphragmatic pressure\/maximumal transdiaphragmatic pressure) and fractional inspiratory neural drive to the diaphragm (EMG\n                    <jats:sub>di<\/jats:sub>\n                    \/maximal EMG\n                    <jats:sub>di<\/jats:sub>\n                    ) were also increased (p&lt;0.05) mainly reflecting the reduced denominator.\n                  <\/jats:p>\n                  <jats:p>Symptomatic smokers at risk for COPD had greater exertional dyspnoea and lower exercise tolerance compared with healthy controls in association with greater airways resistance, contractile diaphragmatic effort and fractional inspiratory neural drive to the diaphragm.<\/jats:p>","DOI":"10.1183\/13993003.00077-2016","type":"journal-article","created":{"date-parts":[[2016,8,4]],"date-time":"2016-08-04T22:43:31Z","timestamp":1470350611000},"page":"694-705","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":88,"title":["Mechanisms of exertional dyspnoea in symptomatic smokers without COPD"],"prefix":"10.1183","volume":"48","author":[{"given":"Amany F.","family":"Elbehairy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan A.","family":"Guenette","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azmy","family":"Faisal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey E.","family":"Ciavaglia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A.","family":"Webb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Jensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew H.","family":"Ramsook","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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