The effect of inhaled nitric oxide on dyspnea and exercise capacity in mild COPD
Bibliographic record
Abstract
Introduction: Patients with mild COPD have an exaggerated ventilatory response to exercise, contributing to exertional dyspnea and exercise intolerance. Objectives: To determine the effect of inhaled nitric oxide (iNO) on ventilation, dyspnea and exercise capacity in patients with mild COPD. Methods: Fifteen patients with mild COPD (FEV1=89±11 %predicted) and fifteen healthy controls completed incremental cycle exercise tests while breathing either normoxia (placebo) or 40 parts per million iNO. Peak work rate was defined as the greatest work rate that patients were able to maintain for at least 30 seconds. Ventilation relative to carbon dioxide production (V̇E/V̇CO2) and oxygen uptake were evaluated using expired gas data. Dyspnea was evaluated using a modified Borg scale. Cardiac output was estimated by impedance cardiography and systemic vascular conductance was calculated as cardiac output/mean arterial pressure. Results: Inhaled NO increased peak work rate (115±8 vs 101±7 Watts, p<0.001) and peak oxygen uptake (1.80±0.14 vs 1.53±0.10 L/min, p=0.002) in COPD, compared to placebo, while no effect was observed in controls. At the highest equivalent work rate of 60 Watts, iNO reduced V̇E/V̇CO2 (32.6±0.9 vs 36.4±1.4, p=0.002) and dyspnea (2.2±0.3 vs 3.3±0.3 Borg units, p=0.002) in COPD, while no effect was observed in controls. Cardiac output and vascular conductance were unaffected by iNO in both groups. Conclusions: Inhaled NO increased exercise capacity in mild COPD, secondary to reduced ventilation (lower V̇E/V̇CO2) and dyspnea. These data suggest that mild COPD patients demonstrate pulmonary vascular dysfunction that contributes to exercise intolerance, secondary to inefficiencies in gas exchange.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".