title: Dyspnoea: a multidimensional and multidisciplinary approach.
abstract: Dyspnoea is a debilitating symptom that affects quality of life, exercise tolerance and mortality in various disease conditions/states. In patients with chronic obstructive pulmonary disease (COPD), it has been shown to be a better predictor of mortality than forced expiratory volume in 1 s. In patients with heart disease it is a better predictor of mortality than angina. Dyspnoea is also associated with decreased functional status and worse psychological health in older individuals living at home. It also contributes to the low adherence to exercise training programmes in sedentary adults and in COPD patients. The mechanisms of dyspnoea are still unclear. Recent studies have emphasised the multidimensional nature of dyspnoea in the sensory-perceptual (intensity and quality), affective distress and impact domains. The perception of dyspnoea involves a complex chain of events that depend on varying cortical integration of several afferent/efferent signals and coloured by affective processing. This review, which stems from the European Respiratory Society research symposium held in Paris, France in November 2012, aims to provide state-of-the-art advances on the multidimensional and multidisciplinary aspects of dyspnoea, by addressing three different themes: 1) the neurophysiology of dyspnoea, 2) exercise and dyspnoea, and 3) the clinical impact and management of dyspnoea.
authors: Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1158, Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005, Paris INSERM, UMR_S 1158, Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005, Paris Centre de Recherche clinique de l'Institut Universitaire de Cardiologie et Pneumologie de Québec (CRIUCPQ), Québec, QC, Canada L. Laviolette and P. Laveneziana have contributed equally and are both first authors.
authors: Louis
authors: L
authors: Laviolette
authors: Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1158, Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005, Paris INSERM, UMR_S 1158, Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005, Paris AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service des Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée, F-75013, Paris Service d'Explorations Fonctionnelles Respiratoires, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU TORINO "Thorax Innovation", INSERM U999, LabEx LERMIT, "Hypertension Artérielle Pulmonaire, Physiopathologie et Innovation thérapeutique", Hôpital Universitaire de Bicêtre (AP-HP), Univ Paris-Sud 11, Le Kremlin-Bicêtre, France L. Laviolette and P. Laveneziana have contributed equally and are both first authors pierantonio.laveneziana@psl.aphp.fr.
authors: Pierantonio
authors: P
authors: Laveneziana
mesh_terms: D003226:Congresses as Topic; D004417:Dyspnea / Q000175:diagnosis* / Q000628:therapy*; D015444:Exercise; D017079:Exercise Tolerance; D005602:France; D006304:Health Status; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology; D015272:Pulmonary Medicine / Q000379:methods*; D012119:Respiration; D016896:Treatment Outcome