Exertional Dyspnoea in Chronic Respiratory Diseases: From Physiology to Clinical Application.
Dyspnoea is a complex, highly personalized and multidimensional sensory experience, and its underlying cause and mechanisms are still being investigated. Exertional dyspnoea is one of the most frequently encountered symptoms of patients with cardiopulmonary diseases, and is a common reason for seeking medical help. As the symptom usually progresses with the underlying disease, it can lead to an avoidance of physical activity, peripheral muscle deconditioning and decreased quality of life. Dyspnoea is closely associated with quality of life, exercise (in)tolerance and prognosis in various conditions, including chronic obstructive pulmonary disease, heart failure, interstitial lung disease and pulmonary hypertension, and is therefore an important therapeutic target. Effective management and treatment of dyspnoea is an important challenge for caregivers, and therapeutic options that attempt to reverse its underlying cause have been only partially successful This "review" will attempt to shed light on the physiological mechanisms underlying dyspnoea during exercise and to translate/apply them to a broad clinical spectrum of cardio-respiratory disorders.
Département de Médecine, Service de Pneumologie, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Canadá.
Bruno-Pierre
BP
Dubé
Chest Service, St Pierre University Hospital, Bruselas, Bélgica.
François
F
Vermeulen
Sorbonne Universités, UPMC Université Paris 06, INSERM, UMRS_1158 Neurophysiologie respiratoire expérimentale et clinique, París, Francia; Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service des Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée (Département «R3S», Pôle PRAGUES), París, Francia. Electronic address: pierantonio.laveneziana@psl.aphp.fr.
Pierantonio
P
Laveneziana
D000339:Affect; D001249:Asthma / Q000150:complications / Q000503:physiopathology; D002908:Chronic Disease; D004417:Dyspnea / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000503:physiopathology; D017563:Lung Diseases, Interstitial / Q000150:complications / Q000503:physiopathology; D009468:Neuromuscular Diseases / Q000150:complications / Q000503:physiopathology; D009765:Obesity / Q000150:complications / Q000503:physiopathology; D005082:Physical Exertion; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology; D011788:Quality of Life; D012140:Respiratory Tract Diseases / Q000150:complications* / Q000503:physiopathology; D012677:Sensation; D016896:Treatment Outcome
Chronic obstructive pulmonary disease; Disnea; Dynamic hyperinflation; Dyspnoea; Enfermedad pulmonar intersticial; Enfermedad pulmonar obstructiva crónica; Hiperinsuflación dinámica; Hipertensión arterial pulmonar; Interstitial lung disease; Mecanismos respiratorios; Pulmonary arterial hypertension; Respiratory mechanics