[The role of altered respiratory mechanics and systemic inflammation in the development of dyspnea in patients with chronic obstructive pulmonary disease].

Evaluation of the state of respiratory muscles during lung hyperinflation and their role in the development of dyspnea in severe chronic obstructive pulmonary disease involved 18 patients with stage III-IV disease (mean age 66.1 +/- 6.5 yr; mean duration of the disease 16.7 +/- 8.4 yr). It included measurements of static lung volume, bronchodilatation response to beta-2 adrenomimetic, strength of respiratory muscles (from maximum inhalation and exhalation pressure) and levels of anti-inflammatory cytokines (IL-6, TNF-alpha) combined with high-resolution CT. It was found that markedly decreased muscular strength and enhanced dyspnea in more than half of the patients were more closely associated with bronchospastic reaction and systemic inflammatory oedema than with hyperinflation. These data confirm priority of anti-inflammatory therapy in patients with severe COPD suffering marked decrease of respiratory muscle strength and positively responding to beta-2 adrenomimetic.