TY - JOUR T1 - Limitation to muscular activity in chronic obstructive pulmonary disease JF - European Respiratory Journal JO - Eur Respir J SP - 6 LP - 7 DO - 10.1183/09031936.04.00038104 VL - 24 IS - 1 AU - K.J. Killian Y1 - 2004/07/01 UR - http://erj.ersjournals.com/content/24/1/6.abstract N2 - The constellation of laboured breathing, fixed inflated lungs that neither fill nor empty properly was first described in 1685 by Willis 1. Post mortem examination revealed that these lungs failed to deflate on opening of the chest 2, and the term emphysema was introduced 3. Chronic bronchitis was viewed as a separate entity occasionally coexisting with emphysema. Airway obstruction was recognised as the key feature of emphysema and chronic bronchitis at the end of the 1950s. This was formally acknowledged at a Ciba Guest Symposium held in 1959 4 and endorsed by the American Thoracic Society in 1962 5. The functional consequences of airway obstruction progress from a reduced capacity to breathe and exchange respiratory gases, to respiratory failure, pulmonary hypertension, right heart failure and premature death. A reduction in the forced expiratory volume in one second (FEV1) and the FEV1/vital capacity ratio, and failure to improve with treatment are the diagnostic features of what is known today as chronic … ER -