{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T20:11:42Z","timestamp":1788293502241,"version":"build-2803163510"},"reference-count":37,"publisher":"European Respiratory Society (ERS)","issue":"4","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2020,9,18]]},"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although the pathophysiological mechanisms involved in the development of dyspnoea and poor exercise tolerance in patients with COPD are complex, dynamic lung hyperinflation (DLH) plays a central role. Diaphragmatic excursions can be measured by ultrasonography (US) with high intra- and interobserver reliability. The objective of this study was to evaluate the effect of diaphragmatic excursions as assessed by US on exercise tolerance and DLH in patients with COPD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients with COPD (n=20) and age-matched control subjects (n=20) underwent US, which was used to determine the maximum level of diaphragmatic excursion (DE\n                      <jats:sub>max<\/jats:sub>\n                      ). Ventilation parameters, including the change in inspiratory capacity (\u0394IC), were measured in the subjects during cardiopulmonary exercise testing (CPET). We examined the correlations between DE\n                      <jats:sub>max<\/jats:sub>\n                      and the ventilation parameters.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The DE\n                      <jats:sub>max<\/jats:sub>\n                      of patients with COPD was significantly lower than that of the controls (45.0\u00b112.8\u2005mm\n                      <jats:italic>versus<\/jats:italic>\n                      64.6\u00b16.3\u2005mm, respectively; p&lt;0.01). The perception of peak dyspnoea (Borg scale) was significantly negatively correlated with DE\n                      <jats:sub>max<\/jats:sub>\n                      in patients with COPD. During CPET, oxygen uptake\/weight (\n                      <jats:italic>V<\/jats:italic>\n                      \u2032\n                      <jats:sub>\n                        O\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      \/\n                      <jats:italic>W<\/jats:italic>\n                      ) and minute ventilation (\n                      <jats:italic>V<\/jats:italic>\n                      \u2032\n                      <jats:sub>E<\/jats:sub>\n                      ) were significantly positively correlated with DE\n                      <jats:sub>max<\/jats:sub>\n                      , while\n                      <jats:italic>V<\/jats:italic>\n                      \u2032\n                      <jats:sub>E<\/jats:sub>\n                      \/\n                      <jats:italic>V<\/jats:italic>\n                      \u2032\n                      <jats:sub>\n                        O\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      and\n                      <jats:italic>V<\/jats:italic>\n                      \u2032\n                      <jats:sub>E<\/jats:sub>\n                      \/carbon dioxide output (\n                      <jats:italic>V<\/jats:italic>\n                      \u2032\n                      <jats:sub>\n                        CO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      ) were significantly negatively correlated with DE\n                      <jats:sub>max<\/jats:sub>\n                      in patients with COPD. DE\n                      <jats:sub>max<\/jats:sub>\n                      was also significantly positively correlated with \u0394IC, reflecting DLH, and with\n                      <jats:italic>V<\/jats:italic>\n                      \u2032\n                      <jats:sub>\n                        O\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      \/\n                      <jats:italic>W<\/jats:italic>\n                      , reflecting exercise capacity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Reduced mobility of the diaphragm was related to decreased exercise capacity and increased dyspnoea due to dynamic lung hyperinflation in COPD patients.<\/jats:p>\n                  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