scholarly journals Neural respiratory drive and breathlessness in COPD

2014 ◽  
Vol 45 (2) ◽  
pp. 355-364 ◽  
Author(s):  
Caroline J. Jolley ◽  
Yuanming M. Luo ◽  
Joerg Steier ◽  
Gerrard F. Rafferty ◽  
Michael I. Polkey ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Tidal Volume ◽  
Pulmonary Disease ◽  
Vital Capacity ◽  
Treadmill Exercise ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Respiratory Drive ◽  
Obstructive Pulmonary Disease ◽  
The Relationship

The aim of this study was to test the hypothesis that neural respiratory drive, measured using diaphragm electromyogram (EMGdi) activity expressed as a percentage of maximum (EMGdi%max), is closely related to breathlessness in chronic obstructive pulmonary disease. We also investigated whether neuroventilatory uncoupling contributes significantly to breathlessness intensity over an awareness of levels of neural respiratory drive alone.EMGdi and ventilation were measured continuously during incremental cycle and treadmill exercise in 12 chronic obstructive pulmonary disease patients (forced expiratory volume in 1 s±sd was 38.7±14.5 % pred). EMGdi was expressed both as EMGdi%max and relative to tidal volume expressed as a percentage of predicted vital capacity to quantify neuroventilatory uncoupling.EMGdi%max was closely related to Borg breathlessness in both cycle (r=0.98, p=0.0001) and treadmill exercise (r=0.94, p=0.005), this relationship being similar to that between neuroventilatory uncoupling and breathlessness (cycling r=0.94, p=0.005; treadmill r=0.91, p=0.01). The relationship between breathlessness and ventilation was poor when expansion of tidal volume became limited.In chronic obstructive pulmonary disease the intensity of exertional breathlessness is closely related to EMGdi%max. These data suggest that breathlessness in chronic obstructive pulmonary disease can be largely explained by an awareness of levels of neural respiratory drive, rather than the degree of neuroventilatory uncoupling. EMGdi%max could provide a useful physiological biomarker for breathlessness in chronic obstructive pulmonary disease.

scholarly journals A multicenter family practitioners’ research on Chronic Obstructive Pulmonary Disease screening using the COPD Assessment Test

2017 ◽  
Vol 18 (06) ◽  
pp. 603-607
Author(s):  
Hakan Demirci ◽  
Koncuy Eniste ◽  
Ebru Onuker Basaran ◽  
Gokhan Ocakoglu ◽  
Zeynep Yilmaz ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Significant Negative Correlation ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Assessment Test ◽  
Apparent Relationship ◽  
The Relationship ◽  
The City

Objectives Spirometry is known to be a gold standard for the diagnosis of chronic obstructive pulmonary disease (COPD). COPD Assessment Test (CAT) is an eight-item questionnaire currently in use to evaluate patients with COPD. In the present study, we aimed to evaluate if CAT is an adequate tool for screening COPD. Methods In total, 600 persons aging ⩾40 years old were randomly selected from three different family practice units located in the city center. CAT was asked to the participants and a spirometry was used to assess pulmonary obstruction. Pulmonary obstruction was defined as forced expiratory volume in first second/forced vital capacity (FEV1/FVC)<70% and then COPD diagnosis was confirmed with the reversibility test. The relationship between CAT results and pulmonary function test values was evaluated. Results In this sampling, the prevalence of COPD was 4.2%. Reliability of the CAT in the study group was acceptable (Cronbach’s α: 0.84). The CAT scores was significantly higher in patients with COPD (P<0.001). There was a significant negative correlation between CAT score and FEV1, FVC and FEV1/FVC ratio (r=−0.31, P<0.001; r=−0.26, P<0.001; r=0.18, P=0.001). Among smokers, phlegm was the predominating symptom (P=0.01). Sensitivity of CAT was 66.67% and its specificity was 75.15% to determine COPD. Conclusions CAT is a reliable questionnaire and there is an apparent relationship between the total CAT scores and COPD. However, CAT’s ability to screen COPD is limited since it may miss the symptom-free cases.

scholarly journals Exclusion Spirometry: A Good Idea

2004 ◽  
Vol 11 (3) ◽  
pp. 185-186
Author(s):  
Nick R. Anthonise
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Pulmonary Disease ◽  
Forced Vital Capacity ◽  
Primary Care Physicians ◽  
Lung Diseases ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

In this issue of theCanadian Respiratory Journal, Almirall and Bégin (pages 195 to 196) make a suggestion aimed at increasing the use of spirometry by primary care physicians, as well as family and general practitioners. The idea is that spirometry should be performed not necessarily to make specific diagnoses, but to rule in or out the possibility of a number of lung diseases, most notably, chronic obstructive pulmonary disease (COPD). If the patient demonstrates normal forced vital capacity and forced expiratory volume in 1 s, then he or she does not have COPD; if the results are not normal, then COPD is a possibility that can be further investigated.

scholarly journals Right heart haemodynamic values and respiratory function test parameters in chronic smokers

2004 ◽  
Vol 10 (1-2) ◽  
pp. 90-95
Author(s):  
M. Gulbaran ◽  
T. Cagatay ◽  
T. Gurmen ◽  
P. Cagatay
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Artery ◽  
Pulmonary Disease ◽  
Respiratory Function ◽  
Vital Capacity ◽  
Respiratory Function Tests ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The Right

During coronary angiography in 24 chronic smokers with coronary heart disease, cardiac function measurements were taken and correlated with respiratory function tests. Fourteen patients had evidence of chronic obstructive pulmonary disease. Cardiac output had a direct correlation with vital capacity, forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1], and velocity at 25% of FVC [V [max] 25]. Pulmonary artery resistance was inversely correlated with FEV1/FVC, while pulmonary artery oxygen saturation weakly correlated with FEV1 and V [max] 25. The pulmonary artery pressure had a weak correlation with the pulmonary artery resistance and an intermediate correlation with the right atrium and the right ventricular pressures. Early diagnosis and therapy of chronic obstructive pulmonary disease in smokers may be possible without using invasive methods

scholarly journals The characteristics of the frequent exacerbator with chronic bronchitis phenotype and non-exacerbator phenotype in patients with chronic obstructive pulmonary disease: a meta-analysis and system review

2020 ◽  
Author(s):  
Jianjun Wu ◽  
Hong-ri Xu ◽  
Ying-xue Zhang ◽  
Yi-xuan Li ◽  
Hui-yong Yu ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Bronchitis ◽  
Pulmonary Disease ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Meta Analysis ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Abstract Objective: To investigate the clinical characteristics between the frequent exacerbator with chronic bronchitis (FE-CB) phenotype and the non-exacerbator (NE) phenotype among patients with chronic obstructive pulmonary disease (COPD). Methods: We searched CNKI, Wan fang, Chongqing VIP, China Biology Medicine disc, PubMed, Cochrane Library, and EMBASE databases for relevant studies published as of April 30, 2019. All studies that investigated COPD patients with the FE-CB and NE phenotypes and which qualified the inclusion criteria were included. Cross-Sectional/Prevalence Study Quality recommendations were used to measure methodological quality. RevMan5.3 software was used for meta-analysis. Results: Ten case-control studies (n=8848) were included. Compared with the NE phenotype, patients with the FE-CB phenotype showed significantly lower forced vital capacity percent predicted (FVC%pred) [mean difference (MD) -6.69, 95% confidence interval (CI) -7.73–-5.65, P<0.001, I2=5%], forced expiratory volume in one second percent predicted (FEV1%pred) (MD -8.50, 95% CI -11.36–-5.65, P<0.001, I2=91%), and forced expiratory volume in one second/forced vital capacity (FEV1/FVC) (MD -3.76, 95% CI -4.58–-2.95,P<0.001, I2=0%); in contrast, the quantity of cigarettes smoked (pack-years) (MD 3.09, 95% CI 1.60–4.58, P<0.001, I2=41%), COPD assessment test (CAT) score (MD 5.61, 95% CI 4.62–6.60, P<0.001, I2=80%), modified Medical British Research Council (mMRC) score (MD 0.72, 95% CI 0.63–0.82, P<0.001, I2=57%), exacerbations in previous year (2.65, 95% CI 2.32–2.97, P<0.001, I2=91%), body mass index (BMI), obstruction, dyspnea, exacerbations (BODEx) (MD 1.78, 95% CI 1.28–2.28, P<0.001, I2=91%), I2=34%), and Charlson comorbidity index (MD 0.47, 95% CI 0.37–0.58, P<0.001, I2=0] were significantly higher in patients with FE-CB phenotype. No significant between-group difference was observed with respect to BMI (MD-0.14, 95% CI -0.70–0.42, P=0.62, I2=75%). Conclusion: COPD patients with the FE-CB phenotype had poorer pulmonary function and higher CAT score, the quantity of cigarettes smoked (pack-years), frequency of acute exacerbations, and mMRC scores than those with the NE phenotype.

scholarly journals A Comparison of Spirometric Parameters and Serum Malondialdehyde Level in Actively Smoking Chronic Obstructive Pulmonary Disease Patients and Non- Smoking Apparently Normals- A Crosssectional Comparative Study

2021 ◽  
pp. 103-110
Author(s):  
. Ranjana ◽  
Mishra Indira Sushil ◽  
Rajiv Ranjan Prasad
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Function ◽  
Pulmonary Disease ◽  
Flow Rate ◽  
Vital Capacity ◽  
Pulmonary Function Tests ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Introduction: The antioxidants requirement depend on one’s exposure to endogenous and exogenous reactive oxygen species.Cigarette smoking leads to increased exposure to reactive oxygen species,hence they require more antioxidant nutrients In this study, we aimed to study the serum levels of malondialdehyde (MDA) as a marker of oxidative stress and pulmonary function tests (PFT) and to study if there is any correlation between PFTand MDA levels in, smokers,chronic obstructive pulmonary disease (COPD) patients. Aim: To compare the pulmonary function tests (PFT) and serum malondialdehyde (MDA) level in smokers, chronic obstructive pulmonary disease (COPD) patients with non-smoker controls. Methods and Materials: N=30, 35-50 years age group smokers, COPD patients were enrolled as cases.N=30 age and sex matched were enrolled as control group. Serum MDA and PFT parameters like forced vital capacity (FVC), forced expiratory volume in first second (FEV1), FEV1/FVC ratio, Peak expiratory flow rate (PEFR) were measured. Result: PFT parameters like forced vital capacity (FVC), forced expiratory volume in first second (FEV1), FEV1/FVC ratio, peak expiratory flow rate(PEFR) were decreased and found statistically significant in smokers, COPD group.MDA level were increase and found statistically highly significant in smokers, COPD group. Conclusion: MDA is negatively correlated with FEV1% predicted, FEV1/FVC % predicted ratio and FVC in smokers, COPD patients

Airflow limitation more than doubles the risk for hospitalization/mortality in patients with heart failure

2019 ◽  
Vol 18 (3) ◽  
pp. 245-252 ◽  
Author(s):  
Andrew Bugajski ◽  
Susan K Frazier ◽  
Debra K Moser ◽  
Misook Chung ◽  
Terry A Lennie
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Patients With Heart Failure

Background: Comorbid chronic obstructive pulmonary disease is found in approximately one-third of patients with heart failure. Survival in patients with chronic obstructive pulmonary disease generally decreases as lung function declines. However, the association between lung function, hospitalization and survival is less clear for patients with heart failure. Aim: The purpose of this study was to determine the predictive power of spirometry measures for event-free survival (combined all-cause hospitalization and/or mortality) in patients with heart failure. Methods: In this secondary analysis of data from three prospective, longitudinal studies, we selected patients with a confirmed diagnosis of heart failure who completed airflow limitation assessment using spirometry measures ( n=137): forced vital capacity, forced expiratory volume/second, and forced expiratory volume/second/forced vital capacity. Cox proportional hazards modeling was used to determine the relationship between spirometry and all-cause hospitalization/mortality with and without adjusting for demographic and clinical covariates over a four-year follow-up period. Results: A majority (74%) exhibited some degree of airflow limitation (forced expiratory volume/second<80% predicted value) and 26 (19%) met the spirometric criterion for chronic obstructive pulmonary disease (forced expiratory volume/second/forced vital capacity⩽0.70). Cox proportional hazards regression models compared all-cause hospitalization/mortality between those with and without airflow limitation. Patients with airflow limitation were 2.2 times more likely to be hospitalized or die compared to those without airflow limitations (hazard ratio: 2.20, 95% confidence interval 1.06–4.53, p=0.03). Conclusion: Patients with comorbid heart failure and airflow limitation were at more than double the risk for an event. Spirometric measures may be useful to patients with heart failure, as tailored management of airflow limitation may impact event-free survival.

scholarly journals Plasma Ghrelin Levels and Weight Loss in Chinese Uygur Patients with Chronic Obstructive Pulmonary Disease

2008 ◽  
Vol 36 (6) ◽  
pp. 1371-1377 ◽  
Author(s):  
BW Ying ◽  
XB Song ◽  
H Fan ◽  
LL Wang ◽  
YS Li ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Factor Α ◽  
Necrosis Factor ◽  
Abnormal Pulmonary Function

Ghrelin is an important orexigenic hormone that reduces fat oxidation and increases adiposity. This study investigated plasma ghrelin levels in Chinese Uygur patients with chronic obstructive pulmonary disease (COPD). Plasma ghrelin and anabolic and catabolic factors were measured in 38 patients and 24 control subjects. COPD patients were divided into two groups based on body mass index (BMI): underweight (BMI ≤ 20 kg/m2, n = 18) or normoweight (BMI ≤ 20 kg/m2, n = 20). Plasma ghrelin levels were found to be significantly higher in underweight than in normoweight patients or healthy controls. Circulating tumour necrosis factor-α and interleukin-6 concentrations were significantly higher in underweight than in normoweight patients, whereas insulin concentrations were significantly lower. Plasma ghrelin levels correlated negatively with forced expiratory volume in 1 s (FEV1; r = 0.35), but did not significantly correlate with FEV1/forced vital capacity. Plasma ghrelin levels were elevated in underweight COPD patients and were associated with cachexia and abnormal pulmonary function.

scholarly journals The characteristics of the frequent exacerbator with chronic bronchitis phenotype and non-exacerbator phenotype in patients with chronic obstructive pulmonary disease: a meta-analysis and system review

2020 ◽  
Author(s):  
jianjun wu ◽  
Hong-ri Xu ◽  
Ying-xue Zhang ◽  
Yi-xuan Li ◽  
Hui-yong Yu ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Bronchitis ◽  
Pulmonary Disease ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Meta Analysis ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Abstract Objective: To investigate the clinical characteristics between the frequent exacerbator with chronic bronchitis (FE-CB) phenotype and the non-exacerbator (NE) phenotype among patients with chronic obstructive pulmonary disease (COPD). Methods: We searched CNKI, Wan fang, Chongqing VIP, China Biology Medicine disc, PubMed, Cochrane Library, and EMBASE databases for relevant studies published as of April 30, 2019. All studies that investigated COPD patients with the FE-CB and NE phenotypes and which qualified the inclusion criteria were included. Cross-Sectional/Prevalence Study Quality recommendations were used to measure methodological quality. RevMan5.3 software was used for meta-analysis. Results: Ten case-control studies (n=8848) were included. Compared with the NE phenotype, patients with the FE-CB phenotype showed significantly lower forced vital capacity percent predicted (FVC%pred) [mean difference (MD) -6.69, 95% confidence interval (CI) -7.73–-5.65, P<0.001, I2=5%], forced expiratory volume in one second percent predicted (FEV1%pred) (MD -8.50, 95% CI -11.36–-5.65, P<0.001, I2=91%), and forced expiratory volume in one second/forced vital capacity (FEV1/FVC) (MD -3.76, 95% CI -4.58–-2.95,P<0.001, I2=0%); in contrast, the quantity of cigarettes smoked (pack-years) (MD 3.09, 95% CI 1.60–4.58, P<0.001, I2=41%), COPD assessment test (CAT) score (MD 5.61, 95% CI 4.62–6.60, P<0.001, I2=80%), modified Medical British Research Council (mMRC) score (MD 0.72, 95% CI 0.63–0.82, P<0.001, I2=57%), exacerbations in previous year (2.65, 95% CI 2.32–2.97, P<0.001, I2=91%), body mass index (BMI), obstruction, dyspnea, exacerbations (BODEx) (MD 1.78, 95% CI 1.28–2.28, P<0.001, I2=91%), I2=34%), and Charlson comorbidity index (MD 0.47, 95% CI 0.37–0.58, P<0.001, I2=0] were significantly higher in patients with FE-CB phenotype. No significant between-group difference was observed with respect to BMI (MD-0.14, 95% CI -0.70–0.42, P=0.62, I2=75%). Conclusion: COPD patients with the FE-CB phenotype had poorer pulmonary function and higher CAT score, the quantity of cigarettes smoked (pack-years), frequency of acute exacerbations, and mMRC scores than those with the NE phenotype.

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