Increased perception of airway narrowing in patients with ild asthma

Carroll, Neil; Klerk, Nicholas De; Elliott, Joseph A.; Musk, Arthur W.; Ryan, Gerard

doi:10.1111/j.1440-1843.1998.tb00129.x

Cited by 9 publications

(10 citation statements)

References 15 publications

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“…We found a strong contribution to dyspnea from the change in FEV 1 , which is consistent with the large number of existing studies that show a close relationship between change in dyspnea and change in FEV 1 . [29][30][31][32] However, in contrast to previous studies, 33 we found no contribution from the change in inspiratory capacity. Instead, the change in reactance was the only other significant contributor to change in dyspnea.…”

Section: Perception Of Dyspneacontrasting

confidence: 99%

“…[30][31][32] However, in the present study, the Borg scores were standardized against methacholine dose to give a measure of perception that makes no assumption about which physiological stimuli are driving the sensation of dyspnea. We found a strong contribution to dyspnea from the change in FEV 1 , which is consistent with the large number of existing studies that show a close relationship between change in dyspnea and change in FEV 1 .…”

Section: Perception Of Dyspneamentioning

confidence: 99%

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Effect of obesity on breathlessness and airway responsiveness to methacholine in non-asthmatic subjects

et al. 2007

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Background: Obesity is associated with increased prevalence and incidence of asthma, but the mechanism is unknown. Obesity reduces lung volumes, which can increase airway responsiveness, and increases resistive and elastic work of breathing, which can increase dyspnea. Objective: To determine if the intensity of dyspnea due to airway narrowing or if airway responsiveness is increased in obese, non-asthmatic subjects. Subjects: Twenty-three obese (BMI (body mass index) X30 kg m À2 ) and 26 non-obese (BMI o30 kg m À2 ) non-asthmatic subjects, aged between 18 and 70 years. Methods: High-dose methacholine challenge was used to determine the sensitivity and the maximal response to methacholine. Respiratory system resistance (Rrs) and reactance were measured, using the forced oscillation technique, as indicators of resistive and elastic loads during challenge. Perception of dyspnea was measured by the Borg score during challenge. Static lung volumes were measured by body plethysmography. Results: Static lung volumes were reduced in the obese subjects. There were no significant differences in the sensitivity or maximal response to methacholine between obese and non-obese subjects. The magnitude of change in Rrs was similar in both groups, but obese subjects had more negative reactance after challenge (P ¼ 0.002) indicating a greater elastic load. The intensity of dyspnea was greater in obese subjects (P ¼ 0.03). Conclusions: Obesity reduces lung volumes, but does not alter the sensitivity or maximal response to methacholine. However, obese subjects have enhanced perception of dyspnea, associated with greater apparent stiffness of the respiratory system, and may therefore be at greater risk of symptoms.

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Section: Perception Of Dyspneacontrasting

confidence: 99%

Section: Perception Of Dyspneamentioning

confidence: 99%

Effect of obesity on breathlessness and airway responsiveness to methacholine in non-asthmatic subjects

et al. 2007

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“…In previous studies PS 20 FEV 1 values have been obtained by direct interpolation of the stimulus-response curve (5,16). Although the PS 20 FEV 1 values in our study were obtained indirectly from the slope and intercept values this difference in methods is unlikely to explain the difference in findings, because evidence that the stimulusresponse relationship is linear over this range (17,18) suggests that they are comparable with values obtained directly. Alternatively, these subjects were volunteers for a clinical trial of inhaled corticosteroid and were recruited on the basis of symptom frequency, so there may have been some self-selection bias in favor of subjects with enhanced perception of symptoms.…”

Section: Discussionsupporting

confidence: 60%

Effect of Budesonide on the Perception of Induced Airway Narrowing in Subjects with Asthma

Salome

Reddel

Ware

et al. 2002

Am J Respir Crit Care Med

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The perception of bronchoconstriction may be modulated by airway inflammation. However, the effect of inhaled corticosteroid (ICS) treatment on perception in subjects with asthma has received limited study. The aim of this study was to determine the effect of inhaled budesonide on the perception of breathlessness induced by histamine challenge. Thirty-five subjects with poorly controlled asthma were randomized to receive budesonide (1,600 or 3,200 g/d) for 8 wk, followed by 8 wk at 1,600 g/d and subsequent downtitration according to a clinical algorithm. Borg scores were recorded during histamine challenges performed at baseline and at 8, 16, 24, 48, and 72 wk. Perception was estimated as the slope of Borg/% fall FEV 1 . The Borg/FEV 1 slope increased significantly after 8 wk of budesonide (0.09 [0.08-0.12] to 0.15 [0.11-0.19], p ϭ 0.002), and remained increased compared with baseline values at all subsequent visits. There were no significant differences in Borg/ FEV 1 slope between subjects who were and were not taking ICS at study entry. The magnitude of change in the Borg/FEV 1 slope did not differ significantly between treatment groups and was not related to changes in baseline FEV 1 , airway hyperresponsiveness, blood eosinophils, or serum eosinophil cationic protein (ECP). We conclude that treatment with budesonide enhances the perception of airway narrowing, but the effect is unrelated to budesonide dose, or to changes in circulating eosinophil markers.

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“…Previous studies on both children and adults have shown that individual ability to perceive airway obstruction induced by bronchial provocation tests or occurring spontaneously varies substantially (2,13,14). Some asthmatics may consider themselves symptom-free in the midst of an asthma attack or feel severe breathlessness during a mild exacerbation.…”

Section: Discussionmentioning

confidence: 99%

Effect of asthma severity on symptom perception in childhood asthma

Cabral

Conceição

Saldiva

et al. 2002

Braz J Med Biol Res

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Individual ability to perceive airway obstruction varies substantially. The factors influencing the perception of asthma are probably numerous and not well established in children. The present study was designed to examine the influence of asthma severity, use of preventive medication, age and gender on the association between respiratory symptoms (RS) and peak expiratory flow (PEF) rates in asthmatic children. We followed 92 asthmatic children, aged 6 to 16 years, for five months. Symptom scores were recorded daily and PEF was measured twice a day. The correlations among variables at the withinperson level over time were analyzed for each child and for the pooled data by multivariate analysis. After pooling the data, there was a significant (P<0.05) correlation between each symptom and PEF; 60% of the children were accurate perceivers (defined by a statistically significant correlation between symptoms and PEF across time) for diurnal symptoms and 37% for nocturnal symptoms. The accuracy of perception was independent of asthma severity, age, gender or the use of preventive medication. Symptom perception is inaccurate in a substantial number of asthmatic children, independently of clinical severity, age, gender or use of preventive medication. It is not clear why some asthmatic patients are capable of accurately perceiving the severity of airway obstruction while others are not.

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Increased perception of airway narrowing in patients with ild asthma

Cited by 9 publications

References 15 publications

Effect of obesity on breathlessness and airway responsiveness to methacholine in non-asthmatic subjects

Effect of obesity on breathlessness and airway responsiveness to methacholine in non-asthmatic subjects

Effect of Budesonide on the Perception of Induced Airway Narrowing in Subjects with Asthma

Effect of asthma severity on symptom perception in childhood asthma

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