Heart or Lungs? Uncovering the Causes of Exercise Intolerance in a Patient with Chronic Cardiopulmonary Disease, 2018, Rocha et al

Webdog

Webdog

Senior Member (Voting Rights)
Heart or Lungs? Uncovering the Causes of Exercise Intolerance in a Patient with Chronic Cardiopulmonary Disease
https://www.atsjournals.org/doi/abs/10.1513/AnnalsATS.201802-073CC

Clinical paper about exercise intolerance in cardiopulmonary disease. I don't have a subscription, so don't know if the cause of exercise intolerance turned out to be heart or lungs.

Maybe someone has access and can follow up on this.
---

A personal note.

A few months ago, a family doctor told me that exercise intolerance was already well known in medicine because of cardiopulmonary disease. And that it might be possible to assign ME/CFS patients similar treatment plans. In other words, use existing resources with no need to create a completely new physio treatment plan specific to ME/CFS. I have no idea how that might work out.
 
Last edited:
Webdog said:
Clinical paper about exercise intolerance in cardiopulmonary disease. I don't have a subscription, so don't know if the cause of exercise intolerance turned out to be heart or lungs.
Click to expand...

Lungs.

http://sci-hub.tw/10.1513/annalsats.201802-073cc

CPET demonstrated that the rise in exertional dyspnea was commensurate with the development of critical mechanical inspiratory constraints. This indicates that the patient's symptoms and exercise intolerance were related primarily to the
respiratory dysfunction (biomass smoke-related COPD and sequelae of pulmonary
tuberculosis) rather than being the consequences of mitral stenosis.
Click to expand...
 
Our PEM is only superficially similar to what happens in other diseases. We may have a similar problem as a consequence of having a chronic disease but ME is a disease of energy metabolism. I can't find the right words for what I am trying to say but the research is teasing it out and soon it might be simpler.

In pulmonary disease after a few steps the patient can't walk any further until they get their breath back. In ME it is common for someone to not know they have done too much until 3 days later. Often the first sign I will get is a sore throat. Lily Chu found that people with ME had a different type of consequence to too much exertion from people with otjer diseases. She might have said inflammatory, but I can't remember.

Patients with cardiopulmonary disease do not get breathless and have to go to bed because they were adding up how much money they spent last month, yet we do.

The findings from the Workwell Insitute that we have a broken aerobic system and need anaerobic respiration to carry out the activities of daily living may explain this. Cardiopulmonary patients will have a functioning aerobic system but something else, lungs or heart is not working properly. That may be relevant to us because small studies have found heart problems but it does not touch the basis of our disease.
 
Mithriel said:
Our PEM is only superficially similar to what happens in other diseases. We may have a similar problem as a consequence of having a chronic disease but ME is a disease of energy metabolism. I can't find the right words for what I am trying to say but the research is teasing it out and soon it might be simpler.

In pulmonary disease after a few steps the patient can't walk any further until they get their breath back. In ME it is common for someone to not know they have done too much until 3 days later. Often the first sign I will get is a sore throat. Lily Chu found that people with ME had a different type of consequence to too much exertion from people with otjer diseases. She might have said inflammatory, but I can't remember.

Patients with cardiopulmonary disease do not get breathless and have to go to bed because they were adding up how much money they spent last month, yet we do.

The findings from the Workwell Insitute that we have a broken aerobic system and need anaerobic respiration to carry out the activities of daily living may explain this. Cardiopulmonary patients will have a functioning aerobic system but something else, lungs or heart is not working properly. That may be relevant to us because small studies have found heart problems but it does not touch the basis of our disease.
Click to expand...
Agree 100%.

Given that doctors already understand and accept that some pulmonary patients physically cannot increase their exercise capacity reduces medical skepticism about exertion intolerance in ME/CFS. Even if the causes, details and treatments of the two conditions are very different.

One cannot exercise their way out of ME/CFS any more than they can exercise their way out of chronic pulmonary disease.
 
You must log in or register to reply here.
Back
Top Bottom