{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T08:16:09Z","timestamp":1787904969032,"version":"build-2784847793"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,1,25]],"date-time":"2023-01-25T00:00:00Z","timestamp":1674604800000},"content-version":"am","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,1,25]],"date-time":"2023-01-25T00:00:00Z","timestamp":1674604800000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","award":["W81XWH\u201016\u20102\u20100018"],"award-info":[{"award-number":["W81XWH\u201016\u20102\u20100018"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["1 IK2 CX001779\u201001A1"],"award-info":[{"award-number":["1 IK2 CX001779\u201001A1"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012308","name":"National Jewish Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012308","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiological Reports"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We identified a case of probable mitochondrial myopathy (MM) in a soldier with dyspnea and reduced exercise tolerance through cardiopulmonary exercise testing (CPET) following Southwest Asia (SWA) deployment. Muscle biopsy showed myopathic features. We compared demographic, occupational exposure, and clinical characteristics in symptomatic military deployers with and without probable MM diagnosed by CPET criteria. We evaluated 235 symptomatic military personnel who deployed to SWA and\/or Afghanistan between 2010 and 2021. Of these, 168 underwent cycle ergometer maximal CPET with an indwelling arterial line. We defined probable MM based on five CPET criteria: arterial peak exercise lactate &gt;12\u2009mEq\/L, anaerobic threshold (AT) \u226450%, maximum oxygen consumption (VO2<jats:sub>max<\/jats:sub>) &lt;95% predicted, oxygen (O2) pulse percent predicted (pp) at least 10% lower than heart rate pp, and elevated ventilatory equivalent for O2 at end exercise (VE\/VO2\u2009\u2265\u200940). We characterized demographics, smoking status\/pack\u2010years, spirometry, and deployment exposures, and used descriptive statistics to compare findings in those with and without probable MM. We found 9\/168 (5.4%) deployers with probable MM. Compared to symptomatic deployers without probable MM, they were younger (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0025) and had lower mean BMI (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.02). They had a higher mean forced expiratory volume (FEV1)<jats:sub>pp<\/jats:sub> (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.02) and mean arterial oxygen partial pressure (PaO2) at maximum exercise (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0003). We found no significant differences in smoking status, deployment frequency\/duration, or inhalational exposures. Our findings suggest that mitochondrial myopathy may be a cause of dyspnea and reduced exercise tolerance in a subset of previously deployed military personnel. CPET with arterial line may assist with MM diagnosis and management.<\/jats:p>","DOI":"10.14814\/phy2.15520","type":"journal-article","created":{"date-parts":[[2023,1,25]],"date-time":"2023-01-25T14:39:37Z","timestamp":1674657577000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Unexplained dyspnea linked to mitochondrial myopathy following military deployment to Southwest Asia and Afghanistan"],"prefix":"10.14814","volume":"11","author":[{"given":"Claudia Daniela","family":"Onofrei","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine National Jewish Health  Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva Brigitte","family":"Gottschall","sequence":"additional","affiliation":[{"name":"Division of Environmental and Occupational Health Sciences, Department of Medicine National Jewish Health  Denver Colorado USA"},{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine University of Colorado Anschutz Medical Campus  Colorado Aurora USA"},{"name":"Department of Environmental and Occupational Health Colorado School of Public Health  Colorado Aurora USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Zell\u2010Baran","sequence":"additional","affiliation":[{"name":"Division of Environmental and Occupational Health Sciences, Department of Medicine National Jewish Health  Denver Colorado USA"},{"name":"Department of Environmental and Occupational Health Colorado School of Public Health  Colorado Aurora USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecile Stephanie","family":"Rose","sequence":"additional","affiliation":[{"name":"Division of Environmental and Occupational Health Sciences, Department of Medicine National Jewish Health  Denver Colorado USA"},{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine University of Colorado Anschutz Medical Campus  Colorado Aurora USA"},{"name":"Department of Environmental and Occupational Health Colorado School of Public Health  Colorado Aurora USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Kraus","sequence":"additional","affiliation":[{"name":"Division of Environmental and Occupational Health Sciences, Department of Medicine National Jewish Health  Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Pang","sequence":"additional","affiliation":[{"name":"Division of Environmental and Occupational Health Sciences, Department of Medicine National Jewish Health  Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4808-3549","authenticated-orcid":false,"given":"Silpa Dhoma","family":"Krefft","sequence":"additional","affiliation":[{"name":"Division of Environmental and Occupational Health Sciences, Department of Medicine National Jewish Health  Denver Colorado USA"},{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine University of Colorado Anschutz Medical Campus  Colorado Aurora USA"},{"name":"Department of Environmental and Occupational Health Colorado School of Public Health  Colorado Aurora USA"},{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine Veterans Administration Eastern Colorado Health Care System  Colorado Aurora 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