The Perception of Dyspnea in Patients With Mild Asthma

Lavietes, Marc H.; Matta, Jyoti; Tiersky, Lana A.; Natelson, Benjamin H.; Bielory, Leonard; Cherniack, Neil S.

doi:10.1378/chest.120.2.409

Cited by 21 publications

(16 citation statements)

References 28 publications

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“…This study confirms the observations of others, namely that measures of dyspnea and measures of airway function correlate poorly in asthmatic subjects [1, 2,20,21,22]. Our data extend previous observations in that we have first utilized a standard 10-unit numerical and categorical scale to measure dyspnea, and second, have included measures of behavioral characteristics of our subjects.…”

Section: Discussionsupporting

confidence: 90%

Dyspnea and Symptom Amplification in Asthma

Lavietes

Ameh²,

Cherniack³

2007

Respiration

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Background: The severity of a patient’s asthma and the intensity with which he describes his dyspnea do not correlate. Objectives: There is an indirect relationship between airway function in asthma and the intensity of dyspnea; this relationship is found only when the measure of a patient’s general tendency to exaggerate the intensity of any somatic symptom is considered simultaneously. Methods: Lung function, including spirometry (forced expiratory volume in 1 s, FEV₁) and plethysmography (airway resistance, R_aw), dyspnea (Borg scale score) and the tendency to exaggerate (the somatosensory amplification scale score, SSAS) have been quantified in 42 stable asthmatic patients. Results: There was no correlation between the Borg score and any spirometric or plethysmographic measure in these subjects. By contrast, there was a moderate correlation between the Borg score and the SSAS (r = 0.36, p = 0.03). However, when FEV₁ or R_aw (abscissa) and Borg scores (ordinate) were converted to residuals, there was a moderate correlation between the residuals and the SSAS score (for FEV₁, r = 0.33 and p = 0.05; for R_aw, r = –0.36 and p = 0.03). Conclusion: A physician may make a reasonable estimate of an asthmatic patient’s lung function from the intensity of his complaint only if he – the physician – considers the patient’s tendency to symptom amplify as well.

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Section: Discussionsupporting

confidence: 90%

Dyspnea and Symptom Amplification in Asthma

Lavietes

Ameh²,

Cherniack³

2007

Respiration

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“…Our study supports previous work that demonstrates a lack of correlation between symptom perception and asthma severity (13,14). African-American participants' comments indicated passivity regarding symptoms due to acclimatization to an inability to inhale, chest tightness, weakness, or dyspnea.…”

Section: Discussionsupporting

confidence: 89%

Descriptors and Perception of Dyspnea in African-American Asthmatics

Trochtenberg

BeLue

2007

Journal of Asthma

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“…Further clouding this issue is how an asthmatic patient perceives and then decides how to treat their asthma symptoms. Numerous studies have demonstrated that some asthmatics are poor perceivers of bronchoconstriction (15,26,28,29). In contrast, very few studies have addressed the issue of poor perception of bronchodilation (2-4.…”

Section: Discussionmentioning

confidence: 99%

“…It is not known whether the poor perception of bronchoconstriction and bronchodilation is caused by the same stimuli (17,26). However, asthma symptom perception and the inter-individual masking of the sensory response to bronchodilators has been widely researched (13,28,29,35). Wraight and colleagues examined the relationship between the severity of bronchoconstiction and tolerance to acute β-agonist therapy in mild-moderate asthmatics (21,24).…”

Section: Discussionmentioning

confidence: 99%

Adrenergic Responsiveness: FEV₁and Symptom Differences in Whites and African Americans with Mild Asthma

2007

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Decision-making about inhaler use is, in part, determined by the ability of asthmatic patients to compare their symptoms over time and to recall the previous response to the bronchodilator during an episode of asthma. The perception of airway symptoms across varied ethnic and cultural groups are poorly understood. Study purpose was (1) to determine if African Americans and Whites with mild asthma could accurately perceive bronchodilation and (2) to identify the word descriptors they used to describe their breathing. Sixteen African American and 16 White patients (34.5 +/- 9.7 years old, mean+/-SD) with mild atopic asthma (FEV1 > or =70% predicted normal) were given increasing doses of an inhaled bronchodilator (Albuterol) after a methacholine challenge. Albuterol (180 microg) was given, by spacer, at 15 min intervals until the FEV1 increased < 5%. Borg, VAS, and Word Descriptors were collected at baseline and after each dose of Albuterol. Baseline FEV1 after Methacholine provocation was 1.94 +/- .39 L for African Americans and 2.13 +/- .70 L for Whites. After 180 microg and again after 360 microg Albuterol, FEV1 increased to 2.88 +/- 0.48 L for African Americans and 3.37 +/- 0.91 L for Whites. But after 540 microg Albuterol, FEV1 decreased significantly (16%) to 2.42 +/- 1.19 L for African Americans while increasing only slightly to 3.47 +/- 0.95 L for Whites. After this dose, 10/16 African Americans felt "tight at the base of throat" (p < 0.01); 7/16 felt "speech-voice-tight" (p < 0.03) suggesting persistent airway discomfort despite marked improvement in FEV1, Borg and VAS scores compared with baseline values. Word descriptors by African Americans' are a more reliable measure of airway symptoms compared to FEV1, Borg or VAS.

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The Perception of Dyspnea in Patients With Mild Asthma

Cited by 21 publications

References 28 publications

Dyspnea and Symptom Amplification in Asthma

Dyspnea and Symptom Amplification in Asthma

Descriptors and Perception of Dyspnea in African-American Asthmatics

Adrenergic Responsiveness: FEV₁and Symptom Differences in Whites and African Americans with Mild Asthma

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The Perception of Dyspnea in Patients With Mild Asthma

Cited by 21 publications

References 28 publications

Dyspnea and Symptom Amplification in Asthma

Dyspnea and Symptom Amplification in Asthma

Descriptors and Perception of Dyspnea in African-American Asthmatics

Adrenergic Responsiveness: FEV1and Symptom Differences in Whites and African Americans with Mild Asthma

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Product

Resources

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Adrenergic Responsiveness: FEV₁and Symptom Differences in Whites and African Americans with Mild Asthma