Variability of Respiratory Symptoms in Severe COPD

Monteros, María José Espinosa de los; Pena, Carolina Silva; Hurtado, EJ Soto; Jareño, Javier; Miravitlles, Marc

doi:10.1016/j.arbr.2011.07.006

Cited by 39 publications

(35 citation statements)

References 18 publications

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“…However, the inclusion was FEV 1 <80% predicted in our study, 44% with moderate COPD (50%< FEV 1 <80% predicted) reported that ≥ one symptom varied during the entire day, which indicated that symptom variability wasn't perceived only in severe COPD patients. If only severe COPD patients enter the statistics in our study, the percent of symptom variability would be 54.5%, which is higher than those in Spanish and European populations (5,6). This difference may attribute to the insufficient treatment because of lower economic level in China.…”

Section: Prevalence Variation and Severity Of Copd Symptomsmentioning

confidence: 77%

“…The present study results concur with the findings in Spanish, Turkish, and the US populations in whom sputum production and cough that peaked during the morning hours were reported to have the highest circadian variability (7). At least over half of all patients (50.2%) with symptomatic COPD perceived variability in one or more symptoms during the day, which is higher than those in Spanish (39.6%) (6) and different European populations (44.7%) (5). All those participants recruited were outpatients with more severe COPD (FEV 1 <50% predicted) (5,6) .…”

Section: Prevalence Variation and Severity Of Copd Symptomsmentioning

confidence: 99%

“…However, this traditional paradigm has been contested in recent decades. Several studies have reported that COPDrelated symptoms are not uniformly perceived by patients in a similar manner, showing not just seasonal variation, but also changes in symptom perception over a week or even during a single day (3)(4)(5)(6)(7)(8)(9). This time-dependent variation is of substantial importance, since it has an impact on everyday life activities and health-related quality of life (HRQoL) (5).…”

Section: Introductionmentioning

confidence: 99%

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Perception of circadian variation of symptoms in Chinese patients with chronic obstructive pulmonary disease

Wang

Cai

et al. 2017

J. Thorac. Dis.

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Background: Although, the variable pattern of asthmatic symptoms is well recognized, little is known about the respiratory symptoms variability in patients of chronic obstructive pulmonary disease (COPD). The present study evaluated the variability of the respiratory symptoms in a day and their influence on the daily activities in a cohort of Chinese COPD patients. Methods: An observational cross-sectional study was conducted in 11 medical centers of China.Participants were outpatient ≥40 years old with stable COPD, post-bronchodilator forced expiratory volume in 1 second (FEV1) <80% predicted. Overall, data of 1,032 eligible patients were valid for final analysis.Results: Mean post bronchodilator FEV1 (predicted %) was 46.5%. Cough, expectoration and dyspnea were the most commonly observed symptoms (73.6%, 68.8% and 61.4%, respectively). Daily symptom variability was experienced by 50.2% of symptomatic patients. The wake up time in the morning was the worst and the most troublesome time during the day (39.3%), followed by the nighttime (21.3%). The morning activities were most affected by COPD symptoms. Multivariate analyses revealed that COPD assessment test (CAT) scores was the only factor correlated with patients' symptom variability [odds ratio (OR) =0.463, P<0.0001]. Conclusions: Patient-perceived symptoms vary during the day in Chinese COPD patients. They experience the greatest increase in respiratory symptoms early in the morning. This variation should be considered as a potential new target in the long-term COPD management.

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Section: Prevalence Variation and Severity Of Copd Symptomsmentioning

confidence: 77%

Section: Prevalence Variation and Severity Of Copd Symptomsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Perception of circadian variation of symptoms in Chinese patients with chronic obstructive pulmonary disease

Wang

Cai

et al. 2017

J. Thorac. Dis.

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“…COPD symptoms vary throughout the day. While some patients report worsening of their symptoms (cough, shortness of breath and phlegm) in the early morning upon awakening, others complain of nocturnal symptoms, most commonly wheezing, shortness of breath and cough which also cause sleep disruption (Kessler et al 2011;Price et al 2013;Lange et al 2014;Agusti et al 2011;Stephenson et al 2015;Jen et al 2016;Partridge et al 2009;Espinosa de los Monteros et al 2012;Kuyucu et al 2011;Kim et al 2012;Decramer et al 2013;Miravitlles et al 2014;Tsai et al 2007).…”

Section: Chronic Obstructive Pulmonary Diseasementioning

confidence: 99%

A circadian based inflammatory response – implications for respiratory disease and treatment

Comas

Gordon

Oliver

et al. 2017

Sleep Science Practice

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Circadian clocks regulate the daily timing of many of our physiological, metabolic and biochemical functions. The immune system also displays circadian oscillations in immune cell count, synthesis and cytokine release, clock gene expression in cells and organs of the immune system as well as clock-controlled genes that regulate immune function. Circadian disruption leads to dysregulation of immune responses and inflammation which can further disrupt circadian rhythms. The response of organisms to immune challenges, such as allergic reactions also vary depending on time of the day, which can lead to detrimental responses particularly during the rest and early active periods. This review evaluates what is currently known in terms of circadian biology of immune response and the cross-talk between circadian and immune system. We discuss the circadian pattern of three respiratory-related inflammatory diseases, chronic obstructive pulmonary disease, allergic rhinitis and asthma. Increasing our knowledge on circadian patterns of immune responses and developing chronotherapeutic studies in inflammatory diseases with strong circadian patterns will lead to preventive measures as well as improved therapies focussing on the circadian rhythms of symptoms and the daily variation of the patients' responses to medication.

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“…It is important to highlight that, many times, the diseases' symptoms are not given value and show a progressive gravity of the obstruction of the air flow which can be determined by the measurement known as the spirometry test from the final expiratory volume forced in the first second of the post-bronchodilator (VEF1%-PBD) 9 . For the elderly, other factors are also cited as possible complicators and thus increase the mortality chances associated with COPD.…”

Section: Introductionmentioning

confidence: 99%