Dyspnea perception in asthma: role of airways inflammation, age and emotional status.
OBJECTIVE
Dyspnea perception in asthmatics differs between subjects. Poor perception is usually associated with increased risk of asthma attack/exacerbation. The advanced stage of the disease and the presence of eosinophilic airways inflammation have been recently recognized as being responsible for poor dyspnea perception. However, few studies are available on this topic.


METHODS
The aim of this study was to analyse the influence of inflammatory pattern, age and affective status on dyspnea perception in asthmatic subjects.


METHODS
Seventy-one consecutive asthmatic patients were recruited and underwent induced sputum, exhaled NO measurement and breath condensate collection. Perception of dyspnea was evaluated as a BORG-VAS/FEV(1) slope before and after the broncho-reversibility test and correlated with the stage of asthma, inflammatory markers, age and depression scale.


RESULTS
Dyspnea perception decreases with the worsening of asthma, with the advance of age and of depression status. Furthermore, airways inflammation plays a key role in the decline of dyspnea perception as proved by the negative correlation observed between inflammatory cells in sputum, exhaled pH and NO and BORG-VAS/FEV(1) slope.


CONCLUSIONS
The results of our study suggested that airways inflammation, depression status, advance age and severity of asthma influence dyspnea perception and suggest a straight control to identify and better manage poor preceptor asthmatics.
Institute of Respiratory Disease, Department of Medical and Occupational Sciences, University of Foggia, Ospedale Colonnello D'Avanzo, Via degli Aviatori 1, 71100 Foggia, Italy.
Maria P Foschino
MP
Barbaro
Donato
D
Lacedonia
Grazia P
GP
Palladino
Laura
L
Bergantino
Cinzia
C
Ruggeri
Domenico
D
Martinelli
Giovanna E
GE
Carpagnano
D000367:Age Factors; D001249:Asthma / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology*; D004417:Dyspnea / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D004644:Emotions; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010465:Perception / Q000502:physiology; D013147:Spirometry; D013183:Sputum / Q000378:metabolism