Patient-Reported Dyspnea Correlates Poorly with Aerobic Exercise Capacity Measured During Cardiopulmonary Exercise Testing

Gaspard, Dany; Kass, Jonathan; Akers, Stephen M.; Hunter, Krystal; Pratter, Melvin R.

doi:10.1007/s00408-017-0043-0

Cited by 4 publications

(4 citation statements)

References 6 publications

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“…Subjective dyspnea is poorly correlated with exercise capacity and VO2peak. 28 Cardiopulmonary exercise testing offers a helpful instrument to differentiate between cardiac, pulmonary and peripheral limitations, thus, motivational problems (eg, persons who desire retirement) can be discovered.…”

Section: Psychosocial Factorsmentioning

confidence: 99%

The importance of return to work: How to achieve optimal reintegration in ACS patients

Reibis

Salzwedel

Abreu

et al. 2019

Eur J Prev Cardiolog

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The vocational reintegration of patients after an acute coronary syndrome is a crucial step towards complete convalescence from the social as well as the individual point of view. Return to work rates are determined by medical parameters such as left ventricular function, residual ischaemia and heart rhythm stability, as well as by occupational requirement profile such as blue or white collar work, night shifts and the ability to commute (which is, in part, determined by physical fitness). Psychosocial factors including depression, self-perceived health situation and pre-existing cognitive impairment determine the reintegration rate to a significant extent. Patients at risk of poor vocational outcomes should be identified in the early period of rehabilitation to avoid a reintegration failure and to prevent socio-professional exclusion with adverse psychological and financial consequences. A comprehensive healthcare pathway of acute coronary syndrome patients is initiated by cardiac rehabilitation, which includes specific algorithms and assessment tools for risk stratification and occupational restitution. As the first in its kind, this review addresses determinants and legal aspects of reintegration of patients experiencing an acute coronary syndrome, and offers practical advice on reintegration strategies particularly for vulnerable patients. It presents different approaches and scientific findings in the European countries and serves as a recommendation for action.

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Section: Psychosocial Factorsmentioning

confidence: 99%

The importance of return to work: How to achieve optimal reintegration in ACS patients

Reibis

Salzwedel

Abreu

et al. 2019

Eur J Prev Cardiolog

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“… 19 20 Low aerobic fitness may contribute to breathlessness 15 21 but has been shown to correlate poorly with reported breathlessness during exercise testing. 22 However, the relationship between aerobic fitness, obesity and breathlessness has not been explored using standardised testing. Psychological conditions such as anxiety or depression are more common in individuals reporting breathlessness and may also contribute to breathlessness through reduced respiratory sensory gating and increased awareness of breathing problems.…”

Section: Introductionmentioning

confidence: 99%

Underlying contributing conditions to breathlessness among middle-aged individuals in the general population: a cross-sectional study

et al. 2020

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IntroductionBreathlessness is common in the general population and associated with poorer health. Prevalence, frequencies and overlap of underlying contributing conditions among individuals reporting breathlessness in the general population is unclear. The aim was to evaluate which conditions that were prevalent, overlapping and associated with breathlessness in a middle-aged general population.MethodCross-sectional analysis of individuals aged 50–65 years in the Swedish CArdioPulmonary bioImage Study pilot. Data from questionnaire, spirometry testing and fitness testing were used to identify underlying contributing conditions among participants reporting breathlessness (a modified Medical Research Scale (mMRC) score ≥1). Multivariate logistic regression was used to identify independent associations with breathlessness.Results1097 participants were included; mean age 57.5 years, 50% women and 9.8% (n=108) reported breathlessness (mMRC ≥1). Main underlying contributing conditions were respiratory disease (57%), anxiety or depression (52%), obesity (43%) and heart disease or chest pain (35%). At least one contributing condition was found in 99.6% of all participants reporting breathlessness, while two or more conditions were present in 66%.ConclusionIn a middle-aged general population, the main underlying contributing conditions to breathlessness were respiratory disease, anxiety or depression, obesity and heart disease or chest pain with a high level of overlap.

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“…The recall was most often not a recall of the intensity of breathlessness but more of the impact and functional disability related to breathlessness. The modified Medical Research Council scale (mMRC) and its varieties [ ], the modified Pulmonary Functional Status Dyspnea Questionnaire [17], and Mahler basal and transient dyspnea index (BDI/TDI) [44] were used. No studies published within the specified time period used a VAS or modified Borg scales for recall of symptoms.…”

Section: Recalled Breathlessnessmentioning

confidence: 99%

Differences between experienced and recalled breathlessness: a review

Sandberg

Ekström²

2019

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of reviewExperienced breathlessness and recalled breathlessness are two different entities, which may be associated with different factors and might have different impacts on function for the individual. The aim was to review the knowledge from the last 2 years concerning experienced breathlessness and recalled breathlessness and related factors. Recent findingsExperienced breathlessness was most often induced or measured during exercise testing in a lab environment using a modified Borg scale. It was associated with both psychological factors, such as social rejection, presence of others, psychosocial stress and prenatal exposure to stress, as well as physical factors, such as hypoxia and frequent exacerbations. Recalled breathlessness was most often measured in epidemiological studies, most commonly using the modified Medical Research Council scale. It was associated with lung volumes, overweight, exercise training, frailty, smoking, personality traits, behavior and marital and occupational status. SummaryNo studies during the review period had directly compared experienced breathlessness and recalled breathlessness. Several factors were related to either experienced breathlessness or recalled breathlessness but no clear differences between factors were found in this review. There is a need for comparative studies using the same measurement methods and in the same settings in order to examine their relation.

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Patient-Reported Dyspnea Correlates Poorly with Aerobic Exercise Capacity Measured During Cardiopulmonary Exercise Testing

Abstract: Patient-reported dyspnea correlates poorly with MaxVO2 and fails to predict exercise capacity. Reliance on reported dyspnea may result in suboptimal categorization of cardiopulmonary disease severity.

Cited by 4 publications

References 6 publications

The importance of return to work: How to achieve optimal reintegration in ACS patients

The importance of return to work: How to achieve optimal reintegration in ACS patients

Underlying contributing conditions to breathlessness among middle-aged individuals in the general population: a cross-sectional study

Differences between experienced and recalled breathlessness: a review

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