Does small airways disease effect exercise response in mild chronic obstructive pulmonary disease?

It?s known that, in Chronic Obstructive Pulmonary Disease (COPD) the airways having a diameter smaller than 2 mm, are the basic areas of airway obstruction; and as disease severity increases, inflamatory and architectural differences increase. Recently cardiopulmonary exercise tests started to be used for evaluating the exercise capacity in clinical practice.Invetigations for evaluating small airways markers by cardiopulmonary exercise test parameters in symptomatic mild cases with COPD, proposed that; increasing ventilatory requirement is the evidence of small airways disfunction. If it?s took in consideration that Forced Expiratory Volume In One Second (FEV1) is commonly used for diagnosis and follow up of patients with COPD, but FEV1 is not an effective parameter for estimating the disease prognose,the small airways parameters can be used in COPD risk group cases and in differential diagnosis of mild COPD. Also small airways parameters are in relationship with response parameters to exercise. Results to be obtained except FEV1,can lead to the usage of small airways parameters in COPD diagnosis. For this reason in our investigation, according to GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteriae, among risk groups for COPD and cases with mild COPD, we investigated if there are any differences at the severity of small airway disease, and differences in small airways parameters in respond to exercise by using cardiopulmonary exercise tests.In our investigation we found no significant differences between two groups for physical examination signs, comorbidities, degree of dispne except there were differences in age. In mild COPD groups predicted FRC, FRCN2, FEF50, FEF25 75 % were statistically different from control group. The effects of age was observed to persist significantly at spirometric parameters. In the evaluation of small airways disease with the aim to demonstrate, although slightly higher in COPD cases, there was no statistically significant differences between sacin an scan. In the analyze differences between ages, a small differency between the two groups did not reach a statistical significant difference in levels were obtained. There was not also statistical significant difference between cardiopulmoner exercise testes parameters. Although it is an important parameter of gas exchange there wasn?t also statistical significant difference between VE/VCO2 but it was over the normal value of 34 in group with mild COPD. These findings supports gase exchange is important in mild COPD.Results showed that, tobacco use regardless of age creates statistical significant airway obstruction in some cases. This might be related to genetic susceptibility. In mild COPD and groups at risk, respons to exercise is similar, but functional impairment in patients with COPD is more related to small airway damage more than cases at risk.