PREDICTORS OF SEVERE DYSPNEA IN PATIENTS WITH MODERATE-TO-SEVERE CHRONIC OBSTRUCTIVE PULMONARY DISEASE
https://doi.org/10.18093/0869-0189-2014-0-2-55-59
Abstract
The aim of this study was to determine early predictors of COPD course.
Methods. In 88 COPD patients (GOLD II) aged 41–79 years, clinical data, spirometry, body plethysmography, bronchial hyperresponsiveness (BHR) in methacholine challenge test, and blood concentrations of IL-6 and IL-8 were analyzed. The patients were divided into two groups according to dyspnea severity: the 1st group (MRC 0–2) included 48 patients, the 2nd group (MRC 3) included 40 patients. Determinants of different severity of dyspnea were identified using the discriminant analysis.
Results. FEV1 values were similar in both groups. The most important determinants of severe dyspnea in COPD patients were duration of the disease (p < 0.001), frequency of exacerbations (p < 0.001), BHR (p < 0.001), lung hyperinflation (p = 0.006), and the patient's age (p = 0.023).
Methods. In 88 COPD patients (GOLD II) aged 41–79 years, clinical data, spirometry, body plethysmography, bronchial hyperresponsiveness (BHR) in methacholine challenge test, and blood concentrations of IL-6 and IL-8 were analyzed. The patients were divided into two groups according to dyspnea severity: the 1st group (MRC 0–2) included 48 patients, the 2nd group (MRC 3) included 40 patients. Determinants of different severity of dyspnea were identified using the discriminant analysis.
Results. FEV1 values were similar in both groups. The most important determinants of severe dyspnea in COPD patients were duration of the disease (p < 0.001), frequency of exacerbations (p < 0.001), BHR (p < 0.001), lung hyperinflation (p = 0.006), and the patient's age (p = 0.023).
About the Authors
I. N. Trofimenko
ГБОУ ДПО "Иркутская государственная медицинская академия последипломного образования" Минздрава России: 664079, Иркутск, мкрн Юбилейный, 100
Russian Federation
Russian Federation
B. A. Chernyak
ГБОУ ДПО "Иркутская государственная медицинская академия последипломного образования" Минздрава России: 664079, Иркутск, мкрн Юбилейный, 100
Russian Federation
Russian Federation
References
1. Айсанов З.Р. Стереотипы в лечении ХОБЛ и их преодоление: уроки исследования UPLIFT. Атмосфера. Пульмонология и аллергология. 2009; 2: 28–34. / Aisanov Z.R. Stereotypes in therapy of COPD and their overcoming: lessons from the UPLIFT trial. Atmosfera. Pulmonologia i allergologia. 2009; 2: 28–34 (in Russian).
2. Rennard S.I., Vestbo J. Natural histories of chronic obstructive pulmonary disease. Proc. Am. Thorac. Soc. 2008; 5:878–883.
3. Vestbo J., Edwards L.D., Scanlon P.D. et al. Changes in forced expiratory volume in 1 second over time in COPD. N. Engl. J. Med. 2011; 365: 1184–1192.
4. Tashkin D.P. Variations in FEV1 decline over time in chronic obstructive pulmonary disease and its implications. Curr. Opin. Pulm. Med. 2013; 19 (2): 116–124.
5. Devanarayan V., Scholand M.B., Hoidal J. et al. Identification of distinct plasma biomarker signatures in patients with rapid and slow declining forms of COPD. COPD 2010; 7:51–58.
6. Wise R.A. The value of forced expiratory volume in 1 second decline in the assessment of chronic obstructive pulmonary disease progression. Am. J. Med. 2006; 119: 4–11.
7. Овчаренко С.И. К вопросу о фенотипах хронической обструктивной болезни легких. Фарматека. 2011; 4:44–46. / Ovcharenko S.I. About phenotypes of chronic obstructive pulmonary disease. Farmateka. 2011; 4: 44–46 (in Russian).
8. Scanlon P.D., Connett J.E., Waller L.A. et al. Smoking cessation and lung function in mild-to moderate chronic obstructive pulmonary disease. The Lung Health Study. Am. J. Respir. Crit. Care Med. 2000; 161: 381–390.
9. Brutsche M.H., Downs S.H., Schindler C. et al. Bronchial hyperresponsiveness and the development of asthma and COPD in asymptomatic individuals: SAPALDIA Cohort Study. Thorax 2006; 61: 671–677.
10. Halpin D.M., Decramer M., Celli B. et al. Exacerbation frequency and course of COPD. Int. J. Chron. Obstruct. Pulm. Dis. 2012; 7: 653–661.
11. Celli B.R., Thomas N.E., Anderson J.A. et al. Effect of pharmacotherapy on rate of decline of lung function in chronic obstructive pulmonary disease: results from the TORCH study. Am. J. Respir. Crit. Care Med. 2008; 178: 332–338.
12. Decramer M., Cell B., Kesten S. et al. Effect of tiotropium on outcomes in patients with moderate chronic obstructive pulmonary disease (UPLIFT): a prespecified subgroup analysis of a randomised controlled trial. Lancet. 2009; 374:1171–1178.
13. Nishimura K., Izumi T., Tsukino M. et al. Dyspnea is a better predictor of 5-year survival than airway obstruction in patients with COPD. Chest. 2002; 121: 1434–1440.
14. Oga T., Nishimura K., Tsukino M. et al. Analysis of the factors related to mortality in chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2003; 167: 544–549.
15. Tantucci C., Modina D. Lung function decline in COPD. Int. J. Chron. Obstruct. Pulm. Dis. 2012; 7: 95–99.
16. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. Updated 2013.
17. Gulsvik A., Refvem O.K. Ascoring system on respiratory symptoms. Eur. Respir. J. 1988; 1: 428–432.
18. Klein G., Kohler D., Bauer C.P. et al. Standartization of inhalation challenges for measuring the unspecific bronchial inhalation challenge by reservuar-method. Pneumologie. 1991; 45: 60–64
19. Стандартизация легочных функциональных тестов: Пер. с англ. под ред. А.Г.Чучалина. М.: 1993: 68–69. / Standardization of Lung Functional Tests. [Standartizatsiya legochnykh funktsional'nykh testov: Per. s angl.]: A.G.Chuchalin (ed.). Transl. from English. Moscow; 1993. 68–69 (in Russian).
20. Овчаренко С.И., Капустина В.А. Хроническая обструктивная болезнь легких: особенности у женщин. Пульмонология 2009; 2: 102–112. / Ovcharenko S.I., Kapustina V.A. Chronic obstructive pulmonary disease in women. Pulmonologia 2009; 2: 102–112 (in Russian).
21. Ucinska R., Damps-Konstanska I., Sieminska A. et al. Chronic obstructive pulmonary disease in women. Pneumonol. Alergol. Pol. 2012; 80 (2): 140–145.
22. Hurst J.R., Vestbo J., Anzueto A. et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N. Engl. J. Med. 2010; 363 (12): 1128–1138.
23. Михалевич И.М., Примина С.П. Применение математических методов при анализе геологической информации (с использованием компьютерных технологий): Учебное пособие. Ч. III. Иркутский гос. университет; 2006. URL: http://ellib.library.isu.ru/docs/geolog/p491_B3_2931.pdf / Mikhalevich I.M., Primina S.P. Application of Mathematical Methods in the Analysis of Geological Information (Using Computer Technology): Manual. [Primenenie matematicheskikh metodov pri analize geologicheskoy informatsii (s ispol'zovaniem komp'yuternykh tekhnologiy): Uchebnoe posobie]: part III. Irkutsk state University; 2006. URL: http://ellib.library.isu.ru/docs/geolog/p491_B3_2931.pdf (in Russian).
24. De Marco R., Accordini S., Marcon A. et al. Risk factors for chronic obstructive pulmonary disease in a European cohort of young adults. Am. J. Respir. Crit. Care Med. 2011; 183 (7): 891–897.
25. Трофименко И.Н., Черняк Б.А. Бронхиальная гиперреактивность как фенотипическая характеристика хронической обструктивной болезни легких. Пульмонология. 2011; 4: 49–53. / Trofimenko I.N., Chernyak B.A. Bronchial hyperreactivity as a phenotypic feature of сhronic obstructive pulmonary disease. Pulmonologia 2011; 4:49–53 (in Russian).
26. Патент РФ № 2480153: МПК A 61B 5/08. Способ прогнозирования течения среднетяжелой хронической обструктивной болезни легких / Черняк Б.А., Трофименко И.Н., Михалевич И.М.; заявитель и патентообладатель ГБОУ ДПО ИГМАПО. № 2012104799/14; заявл. 10.02.2012; опубл. 27.04.2013, Бюл. № 12. / Patent RF N 2480153: MPK A 61B 5/08. A Method to Predict Course of Moderate Сhronic Obstructive Pulmonary Disease / Chernyak B.A., Trofimenko I.N., Mikhalevich I.M.; Applicant and Patent Holder GBOU DPO IGMAPO N2012104799/14; Appl. Data 10.02.2012; published 27.04.2013, Byul. N 12 [Sposob prognozirovaniya techeniya srednetyazheloy khronicheskoy obstruktivnoy bolezni legkikh.] (in Russian).
Review
For citations:
Trofimenko I.N., Chernyak B.A. PREDICTORS OF SEVERE DYSPNEA IN PATIENTS WITH MODERATE-TO-SEVERE CHRONIC OBSTRUCTIVE PULMONARY DISEASE. PULMONOLOGIYA. 2014;(2):55-59. (In Russ.) https://doi.org/10.18093/0869-0189-2014-0-2-55-59
Views:
915
Email this article 