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At least 19 recordsLinked to original sources
PubMed1999

Dyspnea differentiation index: A new method for the rapid separation of cardiac vs pulmonary dyspnea.

STUDY OBJECTIVE: To assess the utility of a new parameter in the differentiation of dyspnea of cardiac origin from dyspnea of pulmonary origin. METHODS: The peak expiratory flow (PEF) rate and the partial pressure of oxygen in arterial blood (PaO(2)) were measured in 71 patients with the chief complaint of dyspnea. The patients were treated in the hospital, and the final diagnosis (cardiac or pulmonary) of the cause of dyspnea was made at discharge. We defined a new measure, the dyspnea differentiation index (DDI), as (PEF x PaO(2))/1,000. We performed a receiver operating characteristic (ROC) curve analysis of the data to define the measure that best distinguished cardiac from pulmonary dyspnea. The curves also allowed us to establish an optimal cut-off point to distinguish between cardiac and pulmonary dyspnea. RESULTS: Patients with pulmonary dyspnea had a significantly lower mean PEF than patients with cardiac dyspnea (144 +/- 66 vs 267 +/- 97 L/min, respectively; p < 0.001). They also had a lower DDI than patients with cardiac dyspnea (8.4 +/- 4.0 vs 18.4 +/- 7.9 L-mm/min, respectively; p < 0.001). These two measures, PEF and DDI, also best distinguished pulmonary from cardiac dyspnea. PEF was able to diagnose the correct cause of dyspnea in 72% of patients, and DDI was correct in 79% of patients. This compares favorably to the performance of the emergency department physicians, who were able to predict the correct diagnosis in only 69% of patients. CONCLUSION: These results demonstrate that the PEF by itself is useful in differentiating between cardiac and pulmonary causes of dyspnea, but that the calculation of DDI is superior in this regard.

Adult↗
PubMed2002

[Dyspnea in COPD: relation to the MRC scale with dyspnea induced by walking and cardiopulmonary stress testing].

OBJECTIVE: Exercise-related dyspnea is the main symptom of chronic obstructive pulmonary disease (COPD), yet its relation to lung function deterioration is weak. The aim of this study was to evaluate the relation between the patients' usual level of dyspnea and dyspnea caused by a maximum cardiopulmonary stress test or a 6-minute walking test. METHODOLOGY: Thirty-six consecutive patients with stable COPD (age 66 7 years post-bronchodilator FEV1 47 14% of predicted) were studied. In addition to full baseline function testing, all patients underwent stress testing on a cycle ergometer and a 6-minute walking test in a corridor 50 m long. Exercise-induced dyspnea was assessed by the patient on a Borg scale before beginning and after completing each test. Chronic dyspnea during activities of daily living was quantified on the Medical Research Council (MRC) scale. RESULTS: The MRC value was only weakly related to percent of predicted FEV1 (r = 0.34, p = 0.04). Parameters obtained during exercise tests that were associated with the MRC were SaO2 at the end of the 6-minute walking test (r = 0.49, p = 0.004) and change in dyspnea on the Borg scale during the 6-minute walking test (deltaBorg-6mWT, r = 0.54, p = 0.0008) and during the stress test (r = 0.35, p = 0.04). Multiple regression analysis, with the MRC result as the dependent variable, showed that deltaBorg-6mWT and SaO2 at the end of the walking test explained 29% of the variance. CONCLUSION: Severity of chronic dyspnea in COPD patients assessed on the MRC scale is more related to dyspnea triggered by the walking test than with dyspnea induced by cycle ergometer stress testing.

Activities of Daily Living↗
PubMed2000

[Quantitative evaluation of dyspnea and the effects of M-receptor antagonist on dyspnea in patients with chronic obstructive pulmonary disease].

OBJECTIVE: To study the method of quantitative evaluation of dyspnea and to investigate the effects of M-receptor antagonist inhalation on dyspnea in patients with chronic obstructive pulmonary disease (COPD) during exercise. METHODS: Cycle exercise test was used in 27 patients with COPD and the effects of ipratropium bromide, a M-receptor antagonist, by inhalation on dyspnea and exercise capacity in the patients were observed. RESULTS: (1) Dyspnea index as Borg scale was closely correlated with oxygen uptake (V(O2)) during exercise in all the patients. Three variables for quantitative evaluation of dyspnea could be derived from the linear regression line. They were Borg scale slope (BSS), threshold load of dyspnea (TLD), and breakpoint load of dyspnea(BLD). (2) BSS was negatively correlated with forced expiratory volume in one second to forced vital capacity ratio (r = -0.519, P < 0.01) and diffusing capacity of the lungs for carbon monoxide (r = -0.497, P < 0.01) but positively correlated with residual volume/total lung capacity (r = 0.396, P < 0.05). (3) Inhalation of ipratropium bromide could significantly improve BSS [from (12.09 +/- 3.41) BS x L(-1) x min(-1) to (8.57 +/- 2.79) BS x L(-1) x min(-1), P < 0.01] and BLD [from (0.77 +/- 0.19) L/min to (0.81 +/- 0.14) L/min, P < 0.05] during exercise. CONCLUSIONS: (1) BSS, TLD and BLD could be used as reliable and convenient variables in quantitative evaluation of dyspnea in patients with COPD. BSS and BLD could to some extent reflect the severity of the disease. (2) M-receptor antagonists could alleviate dyspnea and increase exercise capacity in patients with COPD.

Adult↗
PubMedDate not supplied

Dyspnea in patients with chronic obstructive pulmonary disease: does dyspnea worsen longitudinally in the presence of declining lung function?

OBJECTIVE: To determine the direction and rate of change in the symptom of dyspnea in patients with chronic obstructive pulmonary disease (COPD) whose lung function has worsened over time. DESIGN: Secondary analysis of a longitudinal data set. SETTING: Outpatient clinic. PATIENTS: Thirty-four medically stable male subjects with chronic obstructive pulmonary disease studied for 5.3 +/- 3.5 years, with a mean reduction in FEV1 over the period studied of 330.9 +/- 288.0 mL. Subjects were 63.3 +/- 5.5 years of age at entry into the study. OUTCOME MEASURES: Dyspnea and functional status scores were obtained using the Pulmonary Functional Status and Dyspnea Questionnaire. RESULTS: There was no significant difference in reports of dyspnea from the beginning to the end of the study, despite significant reductions in lung function. Of all activities studied, dyspnea when raising arms overhead was the only activity showing a relationship to the slope of change in FEV1 %. CONCLUSION: These findings suggest that, although patients with chronic lung disease experience varying degrees of deterioration in lung function longitudinally, there is no evidence that they report worsening of dyspnea in tandem with these physiologic changes. In this study, patient ratings of dyspnea longitudinally were not directly linked to changes in lung impairment.

Disease Progression↗
PubMed1995

Treatment of dyspnea in COPD. A controlled clinical trial of dyspnea management strategies.

We conducted a randomized clinical trial to evaluate a limited pulmonary rehabilitation program focused on coping strategies for shortness of breath but without exercise training. Eighty-nine patients with COPD were randomly assigned to either 6-week treatment or general health education control groups. Treatment consisted of instruction and practice in techniques of progressive muscle relaxation, breathing retraining, pacing, self-talk, and panic control. Tests of 6-min walk distance, quality of well-being, and psychological function as well as six dyspnea measures were administered at baseline, posttreatment, and 6 months after the intervention. Baseline pulmonary function tests also were obtained. At the end of the 6-week treatment, there were no significant differences between the treatment and control groups on any outcome measure. At the 6-month follow-up, a significant group difference was seen on only one variable, Mahler's transition dyspnea index. The results of this evaluation suggest that a treatment program of dyspnea management strategies, without structured exercise training or other components of a comprehensive pulmonary rehabilitation program, is not sufficient to produce significant improvement in dyspnea, exercise tolerance, health-related quality of well-being, anxiety, or depression.

Aged↗
PubMed2002

Treatment of cough and dyspnea due to acute bronchitis by plaster for cough and dyspnea--a report of 735 cases.

In the light of the theory of treating the internal disease externally, an externally used plaster for treating cough and dyspnea due to acute bronchitis (Ke Chuan Yi Tie Kang [symbol: see text]-[symbol: see text]) was successfully applied to 735 cases of acute bronchitis (the treatment group), with the other 423 cases treated with routine western drugs as controls. The results showed that the cure rate in the treatment group was significantly higher than that in the control group (P < 0.01); and that in the treatment group, the cure rate for the wind-cold type of acute bronchitis was significantly higher than that for the wind-heat type of acute bronchitis (P < 0.01).

Acupuncture Points↗