![]() m − 2 and those with laboratory findings of hematological, metabolic or neuromuscular diseases, as these factors may confound exercise performance.We excluded subjects with a body mass index ≤18 kg All of the participants were regularly followed-up at our pulmonary outpatient clinics and received optimized and individually tailored drug treatment, and they all had a stable clinical condition for at least 1 month. All of the participants had to be able and willing to perform the study protocol including a maximal or symptom-limited cardiopulmonary exercise test (CPET). The diagnosis of COPD was made by pulmonologists according to the GOLD criteria. The FEV 1/forced vital capacity (FVC) was < 0.7. dL − 1 in males), and no acute illnesses in the recent 1 month. ![]() ![]() We enrolled subjects aged ≥40 years with COPD but without any chronic diseases including uncontrolled diabetes mellitus, uncontrolled hypertension, anemia (hemoglobin < 13 g ![]() This study was conducted in compliance with the Declaration of Helsinki. The local Institutional Review Board of our institutions (CS19014) approved this study. Each subject signed informed consent before entering the study. To obtain invasive measurement data, arterial catheterization was established for blood gas sampling in a subgroup of the participants. ![]() We conducted an observational cross-sectional study on incremental maximal exercise in subjects with COPD at our institution. Exercise ventilatory inefficiency is usually defined as high ventilation ( \( \dot \) and exercise biological homeostasis. ![]()
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