Assessment of bendopnea impact on decompensated heart failure

Abstract

Aims We have often found that patients with heart failure had shortness of breath when bending forward. The frequency of bendopnea in patients with decompensated heart failure (DHF), its repercussions on quality of life (QoL), and its prognosis have not yet been studied. This study was carried out to evaluate the characteristics, degree of limitation, and short‐term prognosis of patients with bendopnea and DHF. Methods and results We conducted a study of 250 patients admitted with DHF. Bendopnea was considered when shortness of breath occurred within 30 s of bending forward. It was present in 122 patients (48.8%). The mean time of onset was 13.4 ± 6.9 s. Patients with bendopnea presented a higher frequency of orthopnoea, paroxysmal nocturnal dyspnoea, oliguria, oedema, elevated jugular venous pressure, abdominal fullness, and worse functional class (P < 0.001). An enlargement of both atria was more frequent in these patients (P < 0.001). Pulmonary artery systolic pressure (PASP) was higher in the bendopnea group (P = 0.001). Body mass index and LVEF were not associated with presence of bendopnea. Subjective QoL limitation was present in 80.3% (36.1% mild, 44.2% moderate to severe limitation). Patients with bendopnea had a higher mortality rate (P = 0.025) and more advanced NYHA class (P < 0.001). Patients who died had a lower LVEF (P = 0.001), increased PASP (P = 0.08), and lower mean duration of shortness of breath than those who survived (P = 0.01). Conclusion Bendopnea is related to advanced HF symptoms and it is associated with mortality in the short term and advanced NYHA functional class. This symptom produces moderate to severe limitation of QoL.

Bendopnea: The next prognostic marker of advanced heart failure?

“…We conducted a prospective study in patients with decompensated heart failure admitted to our internal medicine department to evaluate the relationship between bendopnea and symptoms and signs of heart failure, echocardiographic data, readmissions, and mortality. 2 In this study, the relationship between the presence of bendopnea and increased short-term mortality (6 months), especially in those with heart failure with reduced ejection fraction, was confirmed. In addition, patients with bendopnea had a greater limitation when asked for their quality of life.…”

“…It has been confirmed that patients with bendopnea have more adverse hemodynamic parameters, which would support its worst prognosis. [2][3][4] The maneuver to confirm the presence of bendopnea can be done during standard physical examination, which takes less than a minute and does not require technology, so it would be very interesting that other groups confirm our findings to include the analysis of this new symptom in our usual practice.…”

Clinical and prognostic significance of bendopnea in elderly outpatients

“…С целью исключения влияния ожирения на возникновение одышки при наклоне туловища вперед, в представленном исследовании приняли участие пациенты с ИМТ <30 кг/м 2 , авторы не наблюдали ассоциации бендопноэ с ИМТ. В нем не нашло подтверждения связи между ИМТ и бендопноэ [10].…”

“…В исследовании [10] у 122 из 250 (48,8%) пациентов старшего возраста с ХСН имелось бендопноэ наряду с одышкой (99,2%; р=0,014), ортопноэ (59%; р<0,001), пароксизмальной ночной одышкой (28,7%; р<0,008), гепатомегалией (26,2%; р=0,038). Повторно были госпитализированы 62,3% пациентов и установлена связь бендопноэ с нарастанием риска смерти у пациентов с ХСН III-IV ФК (ОШ 2,3, 95% ДИ 1,05-5,14).…”

Bendopnea: A new symptom for the differential diagnosis of chronic cardiopulmonary disease?

“…3 It also appears to be related to shortterm mortality. 2 In functional studies using cardiopulmonary exercise testing, bendopnea was associated with elevated VE/VCO 2 . 4 In their study published in this issue of the Journal, Martinez Cerón et al analyze the association between different forms of dyspnea and chronic non-communicable diseases, particularly cardiopulmonary disease, in primary health care.…”