Impaired exercise ventilatory efficiency in smokers with low transfer factor but normal spirometry

• Published in: The European respiratory journal Vol. 49; no. 3; p. 1602511
• Main Authors: Walter Barbosa, Gisele, Neder, J Alberto, Utida, Karina, O'Donnell, Denis E, de Tarso Müller, Paulo
• Format: Journal Article
• Language: English
• Published: England European Respiratory Society Journals Ltd 01-03-2017
• Subjects: Carbon monoxide; Chronic obstructive pulmonary disease; Hypoxia; Lung diseases; Obstructive lung disease; Transfer factor
• ISSN: 0903-1936; 1399-3003
• DOI: 10.1183/13993003.02511-2016

It has long been established that severe decrements in transfer factor for carbon monoxide (TLCO) are associated with negative outcomes in patients with chronic obstructive pulmonary disease (COPD), including exertional hypoxaemia and poor exercise tolerance [1]. More recently, exercise capacity has been found to be diminished in smokers both with and without airflow limitation, with mild-to-moderate decrements in TLCO [2–4]. The mechanisms that link reduced TLCO to low exercise capacity in smokers without COPD, even in the absence of increased hypoxic drive or overtly abnormal lung mechanics remain unknown.