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Mechanisms of activity-related breathlessness in healthy human pregnancy

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Abstract

We examined the contribution of alterations in central ventilatory control, static and dynamic respiratory mechanics and their interaction to exertional breathlessness in healthy human pregnancy. Detailed ventilatory, respiratory mechanical/muscular and perceptual responses to incremental cycle exercise were compared in the third trimester (TM3) and again ∼5 months post-partum (PP) in women with (B, n = 12) and without (NB, n = 15) clinically significant activity-related breathlessness (measured by the baseline dyspnea index). In contrast to NB, breathlessness intensity ratings were significantly higher at any given work rate during exercise in TM3 versus PP within B. This difference could not be explained by differences in central ventilatory control or respiratory mechanical/muscular factors. When compared with NB, the B group had an exaggerated ventilatory response to exercise in PP and TM3, and appeared to lack central desensitization to the perceptual effects of maternal hyperventilation that was manifest within the NB group. In conclusion, gestational breathlessness could not be explained by alterations in central ventilatory control or respiratory mechanical/muscular factors, but reflected the normal awareness of increased ventilation.

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Acknowledgments

The authors would like to acknowledge Dr. Larry A. Wolfe (25 May 1950–29 July 2005) for his contribution to the original study design and grant application. This research was funded by the Ontario Thoracic Society (Grant-in Aid); Ontario Thoracic Society (Block Term Grant); and William M. Spear Endowment Fund for Respiratory Research at Queen’s University. D. Jensen was supported by an Ontario Graduate Scholarship and the John Alexander Stewart Fellowship (Department of Medicine, Queen’s University and Kingston General Hospital).

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Authors and Affiliations

  1. School of Kinesiology and Health Studies, Queen’s University, Kingston, ON, Canada

    Dennis Jensen, Gregory A. L. Davies & Denis E. O’Donnell

  2. Department of Medicine, Queen’s University and Kingston General Hospital, Kingston, ON, Canada

    Dennis Jensen, Katherine A. Webb & Denis E. O’Donnell

  3. Department of Obstetrics and Gynecology, Queen’s University and Kingston General Hospital, Kingston, ON, Canada

    Gregory A. L. Davies

  4. Department of Physiology, Queen’s University, Kingston, ON, Canada

    Denis E. O’Donnell

  5. Respiratory Investigation Unit, Kingston General Hospital, Douglas 5, Room 8-536B, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada

    Dennis Jensen

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  1. Dennis Jensen
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  2. Katherine A. Webb
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  4. Denis E. O’Donnell
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Correspondence to Dennis Jensen.

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Jensen, D., Webb, K.A., Davies, G.A.L. et al. Mechanisms of activity-related breathlessness in healthy human pregnancy. Eur J Appl Physiol 106, 253–265 (2009). https://doi.org/10.1007/s00421-009-1015-8

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