{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T23:40:53Z","timestamp":1789083653056,"version":"build-2803163510"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T00:00:00Z","timestamp":1674172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nIntroduction<\/jats:title>\nAn increase in respiratory rate and expiratory flow limitation can facilitate dynamic hyperinflation (DH), which may cause an element of the intrathoracic pressure in connection with the worsening of venous return, with negative effect on stroke volume (SV) and cardiac output (CO). It has been unclassified, whether poor circulatory adaptation to exercise can be attributed to DH or poor cardio-vascular performance itself in COPD. Only a subset of COPD patients exhibit dynamic hyperinflation during exercise.<\/jats:p>\n<\/jats:sec>\n\nPatients and methods<\/jats:title>\nWe designed a study to show how lung mechanical and cardiovascular parameters change in hyperinflated and non-hyperinflated COPD patients during exercise with a new experimental set-up. Thirty-three COPD patients with similar severity of COPD and left ventricular performance (20 men, 13 women, mean\u00b1SD age: 65,36\u00b16,95 years) participated. We measured the cardiovascular parameters with a non-invasive device (Finometer-pro) including the left ventricular ejection time index (LVETi) and estimated the change of DH with inspiratory capacity (IC) manoeuvres during exercise.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nTwenty-one subjects exhibited DH (DH group) and 12 did not (non-DH group). The measurement results were given in mean \u00b1 SD and difference between the values measured during maximal load and rest also (\u0394X = Xmax.load\u2014Xrest). \u0394SV and \u0394CO were significantly higher in non-DH vs. DH patients (\u0394SV: non-DH 9,7 \u00b1 13,22 ml vs. DH -3,6 \u00b1 14,34 ml, p = 0.0142; \u0394CO: non-DH 2,26 \u00b1 1,46 l\/min vs. DH 0,88 \u00b1 1,35 l\/min, p = 0.0024). LVETi was not different between the two groups. Calculated oxygen delivery (DO2) during maximal load was significantly higher in non-DH group.<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nWe concluded that worse cardiovascular adaptation to exercise of COPD patients can be associated with exercise-induced DH in a similar cardiovascular aged COPD group.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0274585","type":"journal-article","created":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T18:43:56Z","timestamp":1674240236000},"page":"e0274585","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Cardiovascular effects of exercise induced dynamic hyperinflation in COPD patients\u2014Dynamically hyperinflated and non-hyperinflated subgroups"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0317-3364","authenticated-orcid":true,"given":"Jozsef","family":"Lukacsovits","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gergo","family":"Szollosi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8552-1336","authenticated-orcid":true,"given":"Janos T.","family":"Varga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,1,20]]},"reference":[{"key":"pone.0274585.ref001","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.rmed.2009.10.014","article-title":"Breath-by-breath quantification of progressive airflow limitation during exercise in COPD: a new method","volume":"104","author":"S Ma","year":"2010","journal-title":"Respir Med"},{"key":"pone.0274585.ref002","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1152\/jappl.1978.44.2.156","article-title":"Analysis of the configuration of maximum expiratory flow-volume curves","volume":"44","author":"J. Mead","year":"1978","journal-title":"Journal of Applied Physiology"},{"key":"pone.0274585.ref003","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1152\/jappl.1967.22.1.95","article-title":"Significance of the relationship between lung recoil and maximum expiratory flow","volume":"22","author":"J Mead","year":"1967","journal-title":"Journal of Applied Physiology"},{"issue":"5 Suppl 1","key":"pone.0274585.ref004","doi-asserted-by":"crossref","first-page":"219S","DOI":"10.1378\/chest.117.5_suppl_1.219S-a","article-title":"Expiratory flow limitation: Roger S. Mitchell Lecture","volume":"117","author":"J. Milic-Emili","year":"2000","journal-title":"Chest"},{"issue":"4","key":"pone.0274585.ref005","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1183\/09031936.00168708","article-title":"Reliability of ventilatory parameters during cycle ergometry in multicentre trials in COPD","volume":"34","author":"DE O`Donnell","year":"2009","journal-title":"Eur Respir J"},{"issue":"18","key":"pone.0274585.ref006","first-page":"49","article-title":"Heart-lung interactions during mechanical ventilation: the basics","volume":"8","author":"SS Mahmood","year":"2018","journal-title":"Ann trans"},{"issue":"5","key":"pone.0274585.ref007","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1136\/adc.80.5.475","article-title":"Cardiovascular effect of mechanical ventilation","volume":"80","author":"L Shekerdemian","year":"1999","journal-title":"Arch Dis Child"},{"issue":"4","key":"pone.0274585.ref008","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1183\/09031936.00056111","article-title":"Physiological changes during low- and high-intensity noninvasive ventilation","volume":"39","author":"J Luk\u00e1csovits","year":"2012","journal-title":"Eur Respir J"},{"key":"pone.0274585.ref009","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1183\/09031936.00173212","article-title":"Inspiratory pressure during noninvasive ventilation in stable COPD: help the lungs, but do not forget the heart","volume":"41","author":"J Luk\u00e1csovits","year":"2013","journal-title":"Eur Respir J"},{"key":"pone.0274585.ref010","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1161\/01.RES.0000136815.73623.BE","article-title":"Right ventricular myocardium derives from the anterior heart field","volume":"95","author":"S Zaffran","year":"2004","journal-title":"Circ Res"},{"key":"pone.0274585.ref011","doi-asserted-by":"crossref","first-page":"1802277","DOI":"10.1183\/13993003.02277-2018","article-title":"The Global Lung Function Initiative (GLI) Network ERS Clinical Research Collaboration: how international collaboration can shape clinical practice","volume":"53","author":"GLI Network Executive; Members of the GLI Network Executive","year":"2019","journal-title":"Eur Respir J"},{"key":"pone.0274585.ref012","doi-asserted-by":"crossref","unstructured":"Lukacsovits J, Mathe Cs, Losonczy G, Varga JT. Relationship between changes in dynamic hyperinflation and cardiovascular parameters during exercise in patients with COPD. ERS Congress 2019;P: 1633.","DOI":"10.1183\/13993003.congress-2019.PA1633"},{"key":"pone.0274585.ref013","unstructured":"http:\/\/carestreammedical.com\/wp-content\/uploads\/Carestream-EnviteC-Spiroquant-H.pdf (Accessed:2022.06.20)."},{"key":"pone.0274585.ref014","unstructured":"http:\/\/www.finapres.com\/site\/page\/2\/10\/Finometer_PRO\/ (Accessed:2022.06.20)."},{"key":"pone.0274585.ref015","unstructured":"Finometer\u2122 User1s Guide, Version 1.1 0, dd. 2002.05.13. FSM, Finapress Medical Sxstem BV \u00a9 2002 FMS: 117\u2013118."},{"issue":"1","key":"pone.0274585.ref016","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1097\/00126097-200302000-00006","article-title":"Finometer, finger pressure measurements with the possibility to reconstruct brachial pressure","volume":"8","author":"i Guelen","year":"2003","journal-title":"Blood Press Monit"},{"issue":"1","key":"pone.0274585.ref017","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/BF01826057","article-title":"Continuous finger arterial pressure: utility in the cardiovascular laboratory","volume":"1","author":"BP Imholz","year":"1991","journal-title":"Clin Auton Res"},{"issue":"3","key":"pone.0274585.ref018","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/S0008-6363(98)00067-4","article-title":"Fifteen years experience with finger arterial pressure monitoring: assessment of the technology","volume":"38","author":"BP Imholz","year":"1998","journal-title":"Cardiovasc Res"},{"issue":"4 Pt 2","key":"pone.0274585.ref019","first-page":"H742","article-title":"Assessment of Windkessel as a model of aortic input impedance","volume":"255","author":"D Burkhoff","year":"1988","journal-title":"Am J Physiol"},{"issue":"2","key":"pone.0274585.ref020","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1093\/bja\/87.2.212","article-title":"A comparison of cardiac output derived from the arterial pressure wave against thermodilution in cardiac surgery patients","volume":"87","author":"JR Jansen","year":"2001","journal-title":"Br J Anaesth"},{"issue":"2","key":"pone.0274585.ref021","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1152\/japplphysiol.01488.2005","article-title":"Continuous cardiac output monitoring in humans by invasive and noninvasive peripheral blood pressure waveform analysis","volume":"101","author":"Z Lu","year":"2006","journal-title":"J Appl Physiol (1985)"},{"key":"pone.0274585.ref022","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1113\/expphysiol.2005.030262","article-title":"Non-invasive pulsatile arterial pressure and stroke volume changes from the human finger","volume":"90","author":"LW Bogert","year":"2005","journal-title":"Exp Physiol"},{"key":"pone.0274585.ref023","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1152\/jappl.1963.18.5.919","article-title":"Left ventricular ejection time index in man","volume":"18","author":"AM Weissler","year":"1963","journal-title":"J Appl Physiol"},{"issue":"5","key":"pone.0274585.ref024","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1378\/chest.94.5.931","article-title":"Metabolic acidosis during exercise in patients with chronic obstructive pulmonary disease. Use of the V-slope method for anaerobic threshold determination","volume":"94","author":"DY Sue","year":"1988","journal-title":"Chest"},{"issue":"3","key":"pone.0274585.ref025","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1136\/thorax.2003.011494","article-title":"Regional chest wall volumes during exercise in chronic obstructive pulmonary disease","volume":"59","author":"A Aliverti","year":"2004","journal-title":"Thorax"},{"issue":"9","key":"pone.0274585.ref026","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1136\/thx.2004.039115","article-title":"Patterns of dynamic hyperinflation during exercise and recovery in patients with severe chronic obstructive pulmonary disease","volume":"60","author":"I Vogiatzis","year":"2005","journal-title":"Thorax"},{"key":"pone.0274585.ref027","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.resp.2016.08.005","article-title":"Relation of concavity in the expiratory flow-volume loop to dynamic hyperinflation during exercise in COPD","volume":"234","author":"J Varga","year":"2016","journal-title":"Respir Physiol Neurobiol"},{"key":"pone.0274585.ref028","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1556\/036.102.2015.2.7","article-title":"Mechanisms to dyspnoea and dynamic hyperinflation related exercise intolerance in COPD","volume":"102","author":"J Varga","year":"2015","journal-title":"Acta Physiologica Hungarica"},{"issue":"Suppl 5","key":"pone.0274585.ref029","doi-asserted-by":"crossref","first-page":"S639","DOI":"10.21037\/jtd.2018.12.11","article-title":"Smoking and pulmonary complications: respiratory prehabilitation","volume":"11","author":"J Varga","year":"2019","journal-title":"J Thorac Dis"},{"key":"pone.0274585.ref030","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1164\/ajrccm.164.5.2012122","article-title":"Dynamic hyperinflation and exercise intolerance in chronic obstructive pulmonary disease","volume":"164","author":"DE O\u2019Donnell","year":"2001","journal-title":"Am J Respir Crit Care Med"},{"key":"pone.0274585.ref031","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1164\/ajrccm\/148.5.1351","article-title":"Exertional breathlessness in patients with chronic airflow limitation. The role of lung hyperinflation","volume":"148","author":"DE O\u2019Donnell","year":"1993","journal-title":"Am Rev Respir Dis"},{"issue":"2","key":"pone.0274585.ref032","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1002\/wsbm.167","article-title":"Computational models for the study of heart-lung interactions in mammals. Wiley Interdisciplinary Reviews","volume":"4","author":"A. Ben-Tal","year":"2012","journal-title":"Systems Biology and Medicine"},{"issue":"5","key":"pone.0274585.ref033","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1183\/09031936.00151707","article-title":"2008 Effects of hyperinflation on the oxygen pulse as a marker of cardiac performance in COPD","volume":"32","author":"C Vassaux","year":"2008","journal-title":"Eur Respir J"},{"issue":"3","key":"pone.0274585.ref034","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1152\/japplphysiol.00877.2018","article-title":"Impard central hemodynamics in chronic obstructive pulmonary diseaseduring submaximal exercise","volume":"127","author":"JR Smith","year":"2019","journal-title":"J Appl Physiol (1985)"},{"issue":"1","key":"pone.0274585.ref035","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1186\/1465-9921-12-150","article-title":"Dynamic hyperinflation is associated with a poor cardiovascular response to exercise in COPD patients","volume":"12","author":"P. Tzani","year":"2011","journal-title":"Respir Res"},{"issue":"3","key":"pone.0274585.ref036","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1152\/japplphysiol.00526.2019","article-title":"Exploring cardiopulmonary interactions during constant-workload submaximal cycle exercise in COPD patients","volume":"127","author":"P Laveneziana","year":"2019","journal-title":"J Appl Physiol (1985)"},{"key":"pone.0274585.ref037","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1183\/09031936.04.00128903","article-title":"Dynamic hyperinflation and tolerance to interval exercise in patients with advanced COPD","volume":"24","author":"I Vogiatzis","year":"2004","journal-title":"Eur Respir J"},{"issue":"12","key":"pone.0274585.ref038","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1159\/000511266","article-title":"Intrinsic Dynamic Positive End-Expiratory Pressure in Stable Patients with Chronic Obstructive Pulmonary Disease","volume":"99","author":"M Vitacca","year":"2020","journal-title":"Respiration"},{"key":"pone.0274585.ref039","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s11517-008-0370-7","article-title":"Time domain analysis of the arterial pulse in clinical medicine","volume":"47","author":"MF O\u2019Rourke","year":"2009","journal-title":"Medical & Biological Engineering & Computing volume"},{"issue":"5","key":"pone.0274585.ref040","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1093\/ajh\/hpt185","article-title":"U-Shaped Relationship of Left Ventricular Ejection Time Index and All-Cause Mortality","volume":"27","author":"A Anton Haiden","year":"2014","journal-title":"Am J Hypertens"},{"key":"pone.0274585.ref041","unstructured":"Varga J, Szilasi M. A pulmonol\u00f3giai rehabilit\u00e1ci\u00f3 k\u00e9zik\u00f6nyve. SpringMed, Budapest, 2018."},{"issue":"6","key":"pone.0274585.ref042","doi-asserted-by":"crossref","first-page":"3519","DOI":"10.21037\/jtd.2018.05.202","article-title":"Effectiveness of pulmonary rehabilitation and correlations in between functional parameters, extent of thoracic surgery and severity of post-operative complications: randomized clinical trial","volume":"10","author":"A V\u00e1gv\u00f6lgyi","year":"2018","journal-title":"J Thorac Dis"},{"issue":"12","key":"pone.0274585.ref043","doi-asserted-by":"crossref","first-page":"6482","DOI":"10.21037\/jtd.2018.10.104","article-title":"Effectiveness of a 4-week rehabilitation program on endothelial function, blood vessel elasticity in patients with chronic obstructive pulmonary disease","volume":"10","author":"B Szucs","year":"2018","journal-title":"J of Thor Dis"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0274585","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T18:44:47Z","timestamp":1674240287000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0274585"}},"subtitle":[],"editor":[{"given":"Nejka","family":"Potocnik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,1,20]]},"references-count":43,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1,20]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0274585","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,20]]}}}