Original Articles
Prevalence of Hyperventilation Syndrome in Patients Treated for Asthma in a Pulmonology Clinic
E. Martínez-Moragóna,
, M. Perpiñáb, A. Bellochc, A. de Diegob
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emm01v@saludalia.com
Correspondence: Dra. E. Martínez-Moragón. Servicio de Neumología (Medicina Interna). Hospital de Sagunto. Avda. Ramón y Cajal, s/n. 46520 Port de Sagunt. Valencia. España
Correspondence: Dra. E. Martínez-Moragón. Servicio de Neumología (Medicina Interna). Hospital de Sagunto. Avda. Ramón y Cajal, s/n. 46520 Port de Sagunt. Valencia. España
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"apellidos" => "Ochoa" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906602206?idApp=UINPBA00003Z" "url" => "/15792129/0000004100000005/v1_201305150216/S1579212906602206/v1_201305150216/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>" "titulo" => "Prevalence of Hyperventilation Syndrome in Patients Treated for Asthma in a Pulmonology Clinic" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "267" "paginaFinal" => "271" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "E. Martínez-Moragón, M. Perpiñá, A. Belloch, A. de Diego" "autores" => array:4 [ 0 => array:5 [ "preGrado" => "Dra." "nombre" => "E." "apellidos" => "Martínez-Moragón" "email" => array:1 [ 0 => "emm01v@saludalia.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Perpiñá" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "A." "apellidos" => "Belloch" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 3 => array:3 [ "nombre" => "A." "apellidos" => "de Diego" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Hospital de Sagunto, Port de Sagunt, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario La Fe, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universidad de Valencia, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dra. E. Martínez-Moragón. Servicio de Neumología (Medicina Interna). Hospital de Sagunto. Avda. Ramón y Cajal, s/n. 46520 Port de Sagunt. Valencia. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-06-18" "fechaAceptado" => "2004-09-28" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec154069" "palabras" => array:4 [ 0 => "Asthma" 1 => "Hyperventilation syndrome" 2 => "Prevalence" 3 => "Anxiety" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154068" "palabras" => array:4 [ 0 => "Asma" 1 => "Síndrome de hiperventilación" 2 => "Prevalencia" 3 => "Ansiedad" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Although the presence of hyperventilation syndrome can affect the symptoms of patients with asthma, there is very little information available regarding its frequency in Spain. The aim of this study was to investigate the prevalence of hyperventilation syndrome in the asthmatic population treated as outpatients and establish its relationship with anxiety disorders.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">We studied 157 consecutive asthmatic patients (61 men and 96 women; mean [SD] age, 45 [17] years; forced expiratory volume in the first second, 84% [21%] of the predicted value) treated in our outpatients clinic. The patients had stable disease with varying degrees of severity. After collecting demographic data and medical histories, we asked the patients to complete the Spanish versions of the Anxiety Sensitivity Index, the Asthma Symptom Checklist, and the Nijmegen questionnaire; in the latter test, a score of 23 or over was considered diagnostic for hyperventilation syndrome. Finally, patients were evaluated to determine whether they had suffered from panic disorder in the last 6 months (according to the criteria of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders).</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Hyperventilation syndrome was present in 57 asthmatic patients (36%) and panic disorder in 4 patients (2%). The majority of patients with hyperventilation syndrome were women (78% vs 51%; <span class="elsevierStyleItalic">P</span> = .001) and were older (49 vs 42; <span class="elsevierStyleItalic">P</span> = .01); they displayed more basal dyspnea (1.26 vs 0.89 on the Medical Research Council scale; <span class="elsevierStyleItalic">P</span> = .01), greater sensitivity to anxiety (<span class="elsevierStyleItalic">P</span> = .001), and went to the emergency room more often for exacerbations (<span class="elsevierStyleItalic">P</span> = .002). Patients with hyperventilation syndrome scored significantly higher on all subscales of the Asthma Symptoms Checklist. Finally, the variables introduced in the regression analysis (stepwise) to explain the score on the Nijmegen questionnaire (r<span class="elsevierStyleSup">2</span>=0.57) were basal dyspnea and sensitivity to anxiety.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Approximately one third of the asthmatic patients treated in a pulmonology clinic also present hyperventilation syndrome. This cannot be explained by comorbidity of asthma with panic disorder, and is only partly linked to the symptoms associated with hyperventilation that appear during an asthma attack.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Aunque la presencia del síndrome de hiperventilación (SH) puede influir en los síntomas de los pacientes con asma, existe escasa información acerca de su frecuencia en nuestro medio. Nuestro objetivo ha sido investigar la prevalencia de SH entre la población asmática controlada ambulatoria-mente y establecer su relación con los trastornos de ansiedad.</p> <span class="elsevierStyleSectionTitle">Patientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Con este propósito hemos estudiado a 157 asmáticos consecutivos (61 varones, 96 mujeres; edad media ± desviación estándar de 45 ± 17 años; volumen espiratorio forzado en el primer segundo: 84 ± 21%), controlados en nuestras consultas externas, en situación estable y con diferentes grados de gravedad. Tras recoger los datos demográficos y los relativos a su enfermedad, cumplimentaron las versiones españolas del Índice de Sensibilidad a la Ansiedad, el Listado de Síntomas durante un Ataque de Asma y el cuestionario Nijmegen; en este último, una puntuación de 23 o superior se consideró diagnóstica del SH. Finalmente, se valoró si habían presentado un trastorno de pánico en los 6 últimos meses (criterios de la cuarta edición del <span class="elsevierStyleItalic">Manual diagnóstico y estadístico de los trastornos mentales</span>).</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Presentaron SH 57 asmáticos (36%) y trastorno de pánico, 4 (2%). Los pacientes con SH eran mayori-tariamente mujeres (un 78 frente a un 51%; p = 0,001) y te-nían más edad (49 frente a 42; p = 0,01), más disnea basal (1,26 en la escala del Medical Research Council frente a 0,89; p = 0,01), más sensibilidad a la ansiedad (p = 0,001) y acudían más veces a urgencias por agudizaciones (p = 0,002). Los pacientes con SH puntuaron significativamente más alto en todas las subescalas del Listado de Síntomas durante un Ataque de Asma. Por último, las variables introducidas en el análisis de regresión (pasos sucesivos) para explicar la puntuación en el cuestionario Nijmegen (r<span class="elsevierStyleSup">2</span> = 0,57) fueron: disnea basal y sensibilidad a la ansiedad.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Aproximadamente un tercio de los asmáticos controlados en una consulta de neumología presentan además SH. Esto no puede explicarse por la comorbilidad asma-trastorno de pánico y tiene que ver sólo en parte con los síntomas relacionados con la hiperventilación que apare-ce durante un ataque de asma.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">This study was funded in part by RED RESPIRA (RTIC G03/11), Health Research Fund (FIS), Instituto de Salud Carlos III.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:25 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Panic disorder and asthma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "RE Carr" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Asthma" "fecha" => "1999" "volumen" => "36" "paginaInicial" => "143" "paginaFinal" => "152" 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 2 | 4 |
| 2024 October | 28 | 24 | 52 |
| 2024 September | 28 | 26 | 54 |
| 2024 August | 46 | 71 | 117 |
| 2024 July | 27 | 24 | 51 |
| 2024 June | 33 | 31 | 64 |
| 2024 May | 40 | 42 | 82 |
| 2024 April | 16 | 25 | 41 |
| 2024 March | 23 | 18 | 41 |
| 2024 February | 19 | 24 | 43 |
| 2023 March | 3 | 14 | 17 |
| 2023 February | 14 | 23 | 37 |
| 2023 January | 19 | 47 | 66 |
| 2022 December | 19 | 28 | 47 |
| 2022 November | 19 | 33 | 52 |
| 2022 October | 29 | 28 | 57 |
| 2022 September | 16 | 28 | 44 |
| 2022 August | 16 | 36 | 52 |
| 2022 July | 16 | 51 | 67 |
| 2022 June | 15 | 30 | 45 |
| 2022 May | 17 | 41 | 58 |
| 2022 April | 13 | 28 | 41 |
| 2022 March | 18 | 41 | 59 |
| 2022 February | 17 | 31 | 48 |
| 2022 January | 12 | 38 | 50 |
| 2021 December | 13 | 38 | 51 |
| 2021 November | 14 | 49 | 63 |
| 2021 October | 13 | 45 | 58 |
| 2021 September | 17 | 45 | 62 |
| 2021 August | 15 | 30 | 45 |
| 2021 July | 11 | 27 | 38 |
| 2021 June | 18 | 40 | 58 |
| 2021 May | 22 | 32 | 54 |
| 2021 April | 29 | 101 | 130 |
| 2021 March | 26 | 24 | 50 |
| 2021 February | 16 | 29 | 45 |
| 2021 January | 9 | 13 | 22 |
| 2020 December | 8 | 14 | 22 |
| 2020 November | 4 | 10 | 14 |
| 2020 October | 8 | 6 | 14 |
| 2020 September | 8 | 8 | 16 |
| 2020 August | 13 | 17 | 30 |
| 2020 July | 12 | 20 | 32 |
| 2020 June | 5 | 10 | 15 |
| 2020 May | 25 | 24 | 49 |
| 2020 April | 15 | 14 | 29 |
| 2020 March | 12 | 21 | 33 |
| 2020 February | 12 | 22 | 34 |
| 2020 January | 17 | 31 | 48 |
| 2019 December | 16 | 28 | 44 |
| 2019 November | 13 | 15 | 28 |
| 2019 October | 8 | 15 | 23 |
| 2019 September | 7 | 18 | 25 |
| 2019 August | 15 | 10 | 25 |
| 2019 July | 7 | 23 | 30 |
| 2019 June | 4 | 20 | 24 |
| 2019 May | 10 | 19 | 29 |
| 2019 April | 17 | 36 | 53 |
| 2019 March | 10 | 18 | 28 |
| 2019 February | 11 | 15 | 26 |
| 2019 January | 6 | 12 | 18 |
| 2018 December | 8 | 11 | 19 |
| 2018 November | 12 | 5 | 17 |
| 2018 October | 13 | 11 | 24 |
| 2018 September | 9 | 11 | 20 |
| 2018 May | 2 | 0 | 2 |
| 2018 April | 4 | 10 | 14 |
| 2018 March | 5 | 8 | 13 |
| 2018 February | 4 | 5 | 9 |
| 2018 January | 9 | 13 | 22 |
| 2017 December | 9 | 9 | 18 |
| 2017 November | 7 | 3 | 10 |
| 2017 October | 9 | 15 | 24 |
| 2017 September | 6 | 14 | 20 |
| 2017 August | 11 | 14 | 25 |
| 2017 July | 2 | 8 | 10 |
| 2017 June | 8 | 12 | 20 |
| 2017 May | 5 | 11 | 16 |
| 2017 April | 5 | 9 | 14 |
| 2017 March | 2 | 4 | 6 |
| 2017 February | 3 | 6 | 9 |
| 2017 January | 2 | 6 | 8 |
| 2016 December | 9 | 10 | 19 |
| 2016 November | 12 | 10 | 22 |
| 2016 October | 14 | 15 | 29 |
| 2016 September | 9 | 10 | 19 |
| 2016 August | 16 | 7 | 23 |
| 2016 July | 13 | 7 | 20 |
| 2016 March | 3 | 0 | 3 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 91 | 1 | 92 |
| 2015 September | 90 | 19 | 109 |
| 2015 August | 85 | 9 | 94 |
| 2015 July | 171 | 16 | 187 |
| 2015 June | 77 | 11 | 88 |
| 2015 May | 92 | 22 | 114 |
| 2015 April | 105 | 14 | 119 |
| 2015 March | 146 | 10 | 156 |
| 2015 February | 107 | 8 | 115 |
| 2015 January | 66 | 11 | 77 |
| 2014 December | 92 | 12 | 104 |
| 2014 November | 94 | 14 | 108 |
| 2014 October | 117 | 28 | 145 |
| 2014 September | 73 | 11 | 84 |
| 2014 August | 79 | 19 | 98 |
| 2014 July | 62 | 18 | 80 |
| 2014 June | 84 | 17 | 101 |
| 2014 May | 88 | 21 | 109 |
| 2014 April | 96 | 8 | 104 |
| 2014 March | 112 | 17 | 129 |
| 2014 February | 97 | 17 | 114 |
| 2014 January | 75 | 13 | 88 |
| 2013 December | 78 | 13 | 91 |
| 2013 November | 70 | 9 | 79 |
| 2013 October | 62 | 19 | 81 |
| 2013 September | 61 | 21 | 82 |
| 2013 August | 38 | 13 | 51 |
| 2013 July | 73 | 19 | 92 |
| 2013 June | 56 | 25 | 81 |
| 2013 May | 84 | 11 | 95 |
| 2013 April | 44 | 13 | 57 |
| 2013 March | 16 | 2 | 18 |
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