Impaired Cardiovascular Response to Exercise in Patients with Severe Asthma: A Case-Control Study

Athina Georgopoulou1, 2, Laskarina Fotiadou1, Stavros Tryfon1, Zoi Daniil2, 3, Afroditi K. Boutou1, 2, *
1 Department of Respiratory Medicine, G. Papanikolaou Hospital, Thessaloniki, Greece
2 Postgraduate Course, Medical School and Department of Physical Education, University of Thessaly, Larissa, Greece
3 Department of Respiratory Medicine, Medical School, University of Thessaly, Larissa, Greece

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© 2022 Georgopoulou et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Respiratory Medicine, G. Papanikolaou Hospital, Thessaloniki, Exohi, 57010, Greece; Tel: 6946611433; E-mail: afboutou@yahoo.com



Although asthmatics may present reduced exercise capacity, data on their cardiovascular responses during exercise testing have been scarcely investigated. The aim of this pilot case-control study is to test: a) whether double product (DP), an index of cardiovascular reserve, differs among patients with severe and mild-moderate asthma, and b) whether DP is associated with asthma control level, physical activity (PA) and exercise capacity, in asthmatics population.

Materials and Methods:

A group of patients with severe asthma (group S) and a matched group of patients with mild-moderate asthma (group M) was studied. All participants completed asthma control and physical activity (IPAC) questionnaires, lung function measurements and six-minute walk test. The exercise capacity (as 6-minute walk distance (6MWD) and corresponding work), the Borg Dyspnea, the rating of perceived excursion and the average PA METS were recorded.


A total of 18 patients were studied. DP at exercise end was significantly lower in group S, compared to group M (16412.2±4732.1 vs. 18594.8±3984.4 mmHgXbpm; p=0.041) and was moderately associated with % predicted 6MWD (r=0.592; p=0.001). Group S patients were also presented with lower moderate intensity PA, compared to group M, while exercise capacity was similar between the groups. Asthma control level had no impact on exercise capacity nor PA parameters.


Patients with severe asthma may have impaired cardiovascular reserve as established by DP, even when exercise capacity is indifferent from patients with milder disease. As an easy-to-assess parameter, DP may offer further information in the functional evaluation of these patients.

Keywords: Asthma, Physical activity, Exercise capacity, Cardiovascular reserve, Double product, Lung function.