title: Different dyspnoea perception in COPD patients with frequent and infrequent exacerbations.
abstract: Some patients with COPD report frequent acute exacerbations (AECOPD) of the disease (FE), whereas others suffer them infrequently (IE). Because the current diagnosis of exacerbation relies on patient's perception of increased symptoms (mostly dyspnoea), we hypothesised that dyspnoea perception might be different in COPD patients with FE (≥2 exacerbations or 1 hospitalisation due to AECOPD in the previous year) or IE (≤1 exacerbation in the previous year), AECOPD being defined by the institution antibiotics and/or steroids treatment, or hospital admission.
  
  
  
  To test the hypothesis that dyspnoea perception is increased in FE and/or decreased in IE with COPD.
  
  
  
  We compared the perception of dyspnoea (Borg scale), mouth occlusion pressure 0.1 s after the onset of inspiration (P0.1) and ventilatory response to hypercapnia (ΔVE/ΔPETCO2) in 34 clinically stable COPD patients with FE (n=14) or IE (n=20), with similar age, gender, body mass index and degree of airflow limitation. As a reference, we studied a group of age-matched healthy volunteers (n=10) with normal spirometry.
  
  
  
  At rest, P0.1was higher in FE than IE and controls (p<0.01). Compared with controls, the ventilatory response to hypercapnia was equally blunted both in FE and IE (p<0.001). Despite similar spirometry, during rebreathing peak Borg score and ΔBorg were higher (p<0.01) in FE and lower (p<0.01) in IE, than in controls.
  
  
  
  Dyspnoea perception during CO2rebreathing is enhanced in FE and blunted in IE. These differences may contribute to the differential rate of reported exacerbations in FE and IE.
  
  
  
  NCT02113839.
authors: Servei de Pneumologia, Institut Clínic Respiratori, Hospital Clínic, Barcelona, Spain.|Department of Medical and Surgical Sciences, Institute of Respiratory Disease, University of Foggia, Foggia, Italy.
authors: Giulia
authors: G
authors: Scioscia
authors: Servei de Pneumologia, Institut Clínic Respiratori, Hospital Clínic, Barcelona, Spain.|Fundació Clínic per la Recerca Biomèdica, Hospital Clínic, Barcelona, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.|Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors: Isabel
authors: I
authors: Blanco
authors: Fundació Clínic per la Recerca Biomèdica, Hospital Clínic, Barcelona, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.
authors: Ebymar
authors: E
authors: Arismendi
authors: Servei de Pneumologia, Institut Clínic Respiratori, Hospital Clínic, Barcelona, Spain.|Fundació Clínic per la Recerca Biomèdica, Hospital Clínic, Barcelona, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.|Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors: Felip
authors: F
authors: Burgos
authors: Servei de Pneumologia, Institut Clínic Respiratori, Hospital Clínic, Barcelona, Spain.
authors: Concepción
authors: C
authors: Gistau
authors: Department of Medical and Surgical Sciences, Institute of Respiratory Disease, University of Foggia, Foggia, Italy.
authors: Maria Pia
authors: MP
authors: Foschino Barbaro
authors: Pulmonary Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors: Bartolome
authors: B
authors: Celli
authors: Respiratory Investigation Unit and Laboratory of Clinical Exercise Physiology, Queen's University and Kingston General Hospital, Kingston, Ontario, Canada.
authors: Denis E
authors: DE
authors: O'Donnell
authors: Servei de Pneumologia, Institut Clínic Respiratori, Hospital Clínic, Barcelona, Spain.|Fundació Clínic per la Recerca Biomèdica, Hospital Clínic, Barcelona, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.|Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors: Alvar
authors: A
authors: Agustí
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004417:Dyspnea / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D012129:Respiratory Function Tests; D012907:Smoking / Q000453:epidemiology
keywords: COPD Exacerbations; Emphysema