Characterization of dysfunctional breathing using cardiopulmonary exercise testing

Abstract Cardiopulmonary exercise testing (CPET) is emerging as a useful tool in the identification of dysfunctional breathing (DB). We aimed to evaluate the prevalence and functional impact of different patterns of DB in 628 adult patients referred for CPET due to unexplained dyspnoea (August 2019–...

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Main Authors: Sebastian F. Möbus, Chris J. Harding, Catherine L. Taylor, Karl P. Sylvester, Jonathan P. Fuld
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Physiological Reports
Subjects:
Online Access:https://doi.org/10.14814/phy2.70388
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author Sebastian F. Möbus
Chris J. Harding
Catherine L. Taylor
Karl P. Sylvester
Jonathan P. Fuld
author_facet Sebastian F. Möbus
Chris J. Harding
Catherine L. Taylor
Karl P. Sylvester
Jonathan P. Fuld
author_sort Sebastian F. Möbus
collection DOAJ
description Abstract Cardiopulmonary exercise testing (CPET) is emerging as a useful tool in the identification of dysfunctional breathing (DB). We aimed to evaluate the prevalence and functional impact of different patterns of DB in 628 adult patients referred for CPET due to unexplained dyspnoea (August 2019–December 2023). Patients were assigned to four groups following CPET interpretation: normal, breathing pattern disorder (BPD), hyperventilation (HV), and combined BPD with HV (BPDHV). Demographic and CPET performance data were analyzed using non‐parametric tests as appropriate. 94 (15.0%) patients had normal CPETs and 267 (42.5%) were identified as having DB. The remaining 267 were excluded as having alternative diagnoses. Of those with DB, 145 (54.3%) had BPD, 41 (15.4%) had HV, and 81 (30.3%) had BPDHV. VE/VCO2 was significantly increased in HV or BPDHV only (p < 0.001). Patients in all three DB groups exhibited significantly impaired peak VO2 compared to those with normal CPETs (p < 0.001). These CPET findings highlight DB as a common driver of symptoms in unexplained dyspnoea. Over half of patients with DB had isolated BPD, which requires visual inspection of relevant CPET plots to diagnose. Those identified with DB had significantly reduced peak VO2, which may be a useful classifier of functional severity in DB.
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spelling doaj-art-4f024110c8a64f97ab523e71da94396f2025-08-20T02:39:40ZengWileyPhysiological Reports2051-817X2025-06-011311n/an/a10.14814/phy2.70388Characterization of dysfunctional breathing using cardiopulmonary exercise testingSebastian F. Möbus0Chris J. Harding1Catherine L. Taylor2Karl P. Sylvester3Jonathan P. Fuld4School of Clinical Medicine University of Cambridge Cambridge UKLung Function Unit Cambridge University Hospitals NHSFT Cambridge UKSports and Exercise Medicine East Suffolk and North Essex NHSFT Ipswich UKRespiratory Physiology Royal Papworth Hospital NHSFT Cambridge UKVictor Phillip Dahdaleh Heart and Lung Research Institute University of Cambridge Cambridge UKAbstract Cardiopulmonary exercise testing (CPET) is emerging as a useful tool in the identification of dysfunctional breathing (DB). We aimed to evaluate the prevalence and functional impact of different patterns of DB in 628 adult patients referred for CPET due to unexplained dyspnoea (August 2019–December 2023). Patients were assigned to four groups following CPET interpretation: normal, breathing pattern disorder (BPD), hyperventilation (HV), and combined BPD with HV (BPDHV). Demographic and CPET performance data were analyzed using non‐parametric tests as appropriate. 94 (15.0%) patients had normal CPETs and 267 (42.5%) were identified as having DB. The remaining 267 were excluded as having alternative diagnoses. Of those with DB, 145 (54.3%) had BPD, 41 (15.4%) had HV, and 81 (30.3%) had BPDHV. VE/VCO2 was significantly increased in HV or BPDHV only (p < 0.001). Patients in all three DB groups exhibited significantly impaired peak VO2 compared to those with normal CPETs (p < 0.001). These CPET findings highlight DB as a common driver of symptoms in unexplained dyspnoea. Over half of patients with DB had isolated BPD, which requires visual inspection of relevant CPET plots to diagnose. Those identified with DB had significantly reduced peak VO2, which may be a useful classifier of functional severity in DB.https://doi.org/10.14814/phy2.70388breathing pattern disordercardiopulmonary exercise testingdysfunctional breathingdyspnoeaexercise capacityhyperventilation
spellingShingle Sebastian F. Möbus
Chris J. Harding
Catherine L. Taylor
Karl P. Sylvester
Jonathan P. Fuld
Characterization of dysfunctional breathing using cardiopulmonary exercise testing
Physiological Reports
breathing pattern disorder
cardiopulmonary exercise testing
dysfunctional breathing
dyspnoea
exercise capacity
hyperventilation
title Characterization of dysfunctional breathing using cardiopulmonary exercise testing
title_full Characterization of dysfunctional breathing using cardiopulmonary exercise testing
title_fullStr Characterization of dysfunctional breathing using cardiopulmonary exercise testing
title_full_unstemmed Characterization of dysfunctional breathing using cardiopulmonary exercise testing
title_short Characterization of dysfunctional breathing using cardiopulmonary exercise testing
title_sort characterization of dysfunctional breathing using cardiopulmonary exercise testing
topic breathing pattern disorder
cardiopulmonary exercise testing
dysfunctional breathing
dyspnoea
exercise capacity
hyperventilation
url https://doi.org/10.14814/phy2.70388
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