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 . 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.
Ventilatory inefficiency in non-COPD smokers is associated with lower exercise capacity http://ow.ly/Mf7n308Qm5M
Conflict of interest: None declared.
- Received December 11, 2016.
- Accepted January 11, 2017.
- Copyright ©ERS 2017