Original Articles
Impact of Baseline and Induced Dyspnea on the Quality of Life of Patients With COPD
Manuela E. Martínez Francésa, Miguel Perpiñá Torderaa, Amparo Belloch Fusterb, Eva M. Martínez Moragónc,
, Luis Compte Torreroa
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martinez_manfra@gva.es
Correspondence: Dra M.E. Martínez Francés Servicio de Neumología, Hospital Universitario La Fe Avda. Campanar, 2146009 Valencia, Spain
Correspondence: Dra M.E. Martínez Francés Servicio de Neumología, Hospital Universitario La Fe Avda. Campanar, 2146009 Valencia, Spain
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Martínez Francés, Miguel Perpiñá Tordera, Amparo Belloch Fuster, Eva M. Martínez Moragón, Luis Compte Torrero" "autores" => array:5 [ 0 => array:3 [ "nombre" => "Manuela E." "apellidos" => "Martínez Francés" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 1 => array:3 [ "nombre" => "Miguel Perpiñá" "apellidos" => "Tordera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 2 => array:3 [ "nombre" => "Amparo Belloch" "apellidos" => "Fuster" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 3 => array:4 [ "nombre" => "Eva M." "apellidos" => "Martínez Moragón" "email" => array:1 [ 0 => "martinez_manfra@gva.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 4 => array:3 [ "nombre" => "Luis Compte" "apellidos" => "Torrero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario La Fe, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Departamento de Personalidad, Universidad de Valencia, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Comarcal de Sagunto, Sagunto, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dra M.E. Martínez Francés Servicio de Neumología, Hospital Universitario La Fe Avda. Campanar, 2146009 Valencia, Spain" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-02-20" "fechaAceptado" => "2007-09-09" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155179" "palabras" => array:4 [ 0 => "Chronic obstructive pulmonary disease" 1 => "COPD" 2 => "Dyspnea" 3 => "Health-related quality of life" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155180" "palabras" => array:3 [ 0 => "EPOC" 1 => "Disnea" 2 => "Calidad de vida relacionada con la salud" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Dyspnea is the main symptom of chronic obstructive pulmonary disease (COPD) and as such is an important determinant of health-related quality of life. It is, however, weakly correlated to severity of obstruction and there is little information available on how it exercises its effect on health-related quality of life. The aims of this study were to identify the determinants of baseline dyspnea and to ascertain how that factor influences the health-related quality of life of patients with COPD.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 101 patients with COPD were studied. Tests included full lung function assessment, the bronchial provocation test (n=70), and the 6-minute walk test. The following variables were measured: baseline dyspnea, bronchoconstriction-induced dyspnea, exertional dyspnea, health-related quality of life, and levels of anxiety and depression.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Determinants of baseline dyspnea were anxiety (explained variance, 17%), maximum inspiratory pressure (4%), and PaO<span class="elsevierStyleInf">2</span> (4%). In patients with mild to moderate COPD (forced expiratory volume in 1 second, >50% of predicted), the main determinant of health-related quality of life was anxiety (explained variance, 43%). Other determinants were the number of meters walked in the 6-minute-walk test, age, and baseline dyspnea (variance explained by both factors, 26%). Baseline dyspnea and bronchoconstriction-induced dyspnea were both identified as independent determinants of health-related quality of life (on the activity and impact subscales of the St George's Respiratory Questionnaire, respectively). The main determinant of health-related quality of life in patients with severe COPD (forced expiratory volume in 1 second, >50% of predicted) was baseline dyspnea. Finally, the main determinants of anxiety were exertional dyspnea (variance, 42%) and baseline dyspnea (6%).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Anxiety is the main determinant of health-related quality of life in patients with COPD, and it is triggered mainly by baseline dyspnea and exertional dyspnea.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">La disnea es el principal síntoma de la enfermedad pulmonar obstructiva crónica (EPOC), por lo que tiene un papel importante en la calidad de vida relacionada con la salud (CVRS). Sin embargo, guarda una relación débil con la gravedad de la obstrucción y hay pocos datos sobre cómo influye en la CVRS. Así pues, nuestro objetivo ha sido averiguar los determinantes de la disnea basal y cómo influye ésta en la CVRS de los pacientes con EPOC.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se estudió a 101 pacientes con EPOC, a los que se realizaron exploración funcional completa, test de provocación bronquial (n = 70) y test de la marcha (TM). Se midieron la disnea basal, la inducida por broncoconstrictor y por esfuerzo, la CVRS y los grados de ansiedad y depresión.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La disnea basal vino determinada por la ansiedad (un 17% de la variancia explicada), la presión inspiratoria máxima (4%) y la presión arterial de oxígeno (4%). En la EPOC leve-moderada (volumen espiratorio forzado en el primer segundo > 50%) la CVRS se explicó fundamentalmente por la ansiedad (el 43% de la variancia). Los metros caminados en el TM, la edad y la disnea basal explicaron otro 26%. La disnea basal también apareció como determinante independiente de la CVRS en la subescala de Actividades, y la inducida por broncoconstricción en la subescala de Impacto. En la EPOC grave (volumen espiratorio forzado en el primer segundo >50%) la disnea basal fue el determinante fundamental de la CVRS. Los principales determinantes de la ansiedad fueron la disnea provocada por el TM (el 42% de la variancia) y la basal (6%).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La ansiedad es el determinante fundamental de la CVRS en la EPOC; dicha ansiedad está mediada fundamentalmente por la disnea inducida por esfuerzo y la disnea basal.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">This study was funded by grants from RED RESPIRA (RTIC G03/11), the Spanish Health Research Fund (FIS), and Instituto de Salud Carlos III-FEDER.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dyspnea and quality of life in chronic obstructive pulmonary disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "PW Jones" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Dyspnea" "paginaInicial" => "199" "paginaFinal" => "220" "serieFecha" => "1998" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A comparison of the level of dyspnea vs disease severity in indicating the health-related quality of life of patients with COPD" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "T Hajiro" 1 => "K Nishimura" 2 => "M Tsukino" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1999" "volumen" => "116" "paginaInicial" => "1632" "paginaFinal" => "1637" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10593787" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is dyspnea the main determinant of quality of life in the failing lung? 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 2 | 4 |
| 2024 October | 27 | 18 | 45 |
| 2024 September | 29 | 10 | 39 |
| 2024 August | 36 | 30 | 66 |
| 2024 July | 27 | 22 | 49 |
| 2024 June | 37 | 27 | 64 |
| 2024 May | 39 | 29 | 68 |
| 2024 April | 20 | 22 | 42 |
| 2024 March | 20 | 13 | 33 |
| 2024 February | 17 | 17 | 34 |
| 2023 March | 1 | 4 | 5 |
| 2023 February | 15 | 22 | 37 |
| 2023 January | 24 | 23 | 47 |
| 2022 December | 19 | 26 | 45 |
| 2022 November | 15 | 21 | 36 |
| 2022 October | 31 | 25 | 56 |
| 2022 September | 19 | 25 | 44 |
| 2022 August | 22 | 31 | 53 |
| 2022 July | 22 | 40 | 62 |
| 2022 June | 13 | 33 | 46 |
| 2022 May | 16 | 27 | 43 |
| 2022 April | 19 | 26 | 45 |
| 2022 March | 18 | 34 | 52 |
| 2022 February | 18 | 28 | 46 |
| 2022 January | 17 | 37 | 54 |
| 2021 December | 14 | 45 | 59 |
| 2021 November | 15 | 47 | 62 |
| 2021 October | 26 | 48 | 74 |
| 2021 September | 15 | 65 | 80 |
| 2021 August | 9 | 28 | 37 |
| 2021 July | 14 | 31 | 45 |
| 2021 June | 15 | 17 | 32 |
| 2021 May | 12 | 26 | 38 |
| 2021 April | 41 | 69 | 110 |
| 2021 March | 20 | 19 | 39 |
| 2021 February | 11 | 16 | 27 |
| 2021 January | 10 | 15 | 25 |
| 2020 December | 5 | 12 | 17 |
| 2020 November | 13 | 14 | 27 |
| 2020 October | 5 | 5 | 10 |
| 2020 September | 8 | 1 | 9 |
| 2020 August | 12 | 11 | 23 |
| 2020 July | 11 | 12 | 23 |
| 2020 June | 2 | 2 | 4 |
| 2020 May | 10 | 12 | 22 |
| 2020 April | 20 | 16 | 36 |
| 2020 March | 10 | 7 | 17 |
| 2020 February | 21 | 16 | 37 |
| 2020 January | 9 | 15 | 24 |
| 2019 December | 12 | 14 | 26 |
| 2019 November | 13 | 13 | 26 |
| 2019 October | 6 | 7 | 13 |
| 2019 September | 8 | 11 | 19 |
| 2019 August | 15 | 19 | 34 |
| 2019 July | 19 | 13 | 32 |
| 2019 June | 9 | 11 | 20 |
| 2019 May | 17 | 9 | 26 |
| 2019 April | 28 | 24 | 52 |
| 2019 March | 4 | 14 | 18 |
| 2019 February | 11 | 10 | 21 |
| 2019 January | 3 | 7 | 10 |
| 2018 December | 11 | 17 | 28 |
| 2018 November | 17 | 8 | 25 |
| 2018 October | 32 | 9 | 41 |
| 2018 September | 9 | 14 | 23 |
| 2018 May | 4 | 1 | 5 |
| 2018 April | 18 | 7 | 25 |
| 2018 March | 8 | 3 | 11 |
| 2018 February | 10 | 9 | 19 |
| 2018 January | 4 | 5 | 9 |
| 2017 December | 7 | 5 | 12 |
| 2017 November | 7 | 3 | 10 |
| 2017 October | 9 | 10 | 19 |
| 2017 September | 6 | 7 | 13 |
| 2017 August | 11 | 10 | 21 |
| 2017 July | 16 | 9 | 25 |
| 2017 June | 10 | 13 | 23 |
| 2017 May | 6 | 6 | 12 |
| 2017 April | 6 | 7 | 13 |
| 2017 March | 3 | 11 | 14 |
| 2017 February | 5 | 2 | 7 |
| 2017 January | 2 | 4 | 6 |
| 2016 December | 4 | 3 | 7 |
| 2016 November | 10 | 7 | 17 |
| 2016 October | 14 | 11 | 25 |
| 2016 September | 12 | 10 | 22 |
| 2016 August | 10 | 2 | 12 |
| 2016 July | 12 | 5 | 17 |
| 2016 March | 2 | 0 | 2 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 57 | 14 | 71 |
| 2015 September | 72 | 9 | 81 |
| 2015 August | 75 | 14 | 89 |
| 2015 July | 88 | 10 | 98 |
| 2015 June | 54 | 6 | 60 |
| 2015 May | 68 | 7 | 75 |
| 2015 April | 55 | 8 | 63 |
| 2015 March | 70 | 9 | 79 |
| 2015 February | 90 | 4 | 94 |
| 2015 January | 80 | 5 | 85 |
| 2014 December | 61 | 6 | 67 |
| 2014 November | 59 | 9 | 68 |
| 2014 October | 93 | 10 | 103 |
| 2014 September | 67 | 7 | 74 |
| 2014 August | 63 | 9 | 72 |
| 2014 July | 50 | 11 | 61 |
| 2014 June | 69 | 7 | 76 |
| 2014 May | 77 | 11 | 88 |
| 2014 April | 79 | 4 | 83 |
| 2014 March | 82 | 9 | 91 |
| 2014 February | 64 | 9 | 73 |
| 2014 January | 58 | 6 | 64 |
| 2013 December | 53 | 12 | 65 |
| 2013 November | 38 | 7 | 45 |
| 2013 October | 58 | 10 | 68 |
| 2013 September | 75 | 9 | 84 |
| 2013 August | 47 | 12 | 59 |
| 2013 July | 57 | 12 | 69 |
| 2013 June | 38 | 12 | 50 |
| 2013 May | 46 | 10 | 56 |
| 2013 April | 26 | 6 | 32 |
| 2013 March | 15 | 3 | 18 |
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