title: Association of types of dyspnea including 'bendopnea' with cardiopulmonary disease in primary care.
abstract: BACKGROUND
  Dyspnea is the symptom most commonly reported by patients with heart failure (HF) and/or pulmonary disease, the obese and the elderly. Recently 'bendopnea' (shortness of breath when bending forward) has been described in patients with HF.
  
  
  OBJECTIVE
  To determine the association of exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea and bendopnea with chronic disease, especially heart failure, and their phenotypes in primary care.
  
  
  METHODS
  This cross-sectional study included 633 individuals aged between 45 and 99 years enrolled in a primary care program in Niteroi, Brazil. Participants underwent clinical assessment and laboratory tests and completed a questionnaire, all on the same day.
  
  
  RESULTS
  Paroxysmal nocturnal dyspnea and bendopnea were associated with HF (unadjusted OR 2.42, 95% CI 1.10-5.29 and OR 2.59, 95% CI 1.52-4.44, respectively). In multivariate models, chronic obstructive pulmonary disease, coronary heart disease and myocardial infarction were not associated with bendopnea.
  
  
  CONCLUSIONS
  Bendopnea was the only type of dyspnea not linked to respiratory disease or coronary heart disease. Even after adjusting for depression and body mass index, the association remained with HF with or without preserved ejection fraction, and bendopnea thus appears to be a promising symptom to differentiate HF from the other two disease groups.
authors.affiliation: Departamento de Epidemiologia e Bioestatística, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brasil. Electronic address: mcdianamaria@gmail.com.
authors.forename: Diana María
authors.initials: DM
authors.lastname: Martínez Cerón
authors.affiliation: Departamento de Epidemiologia e Bioestatística, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brasil.
authors.forename: Maria Luiza
authors.initials: ML
authors.lastname: Garcia Rosa
authors.affiliation: Departamento de Clínica Médica, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brasil.
authors.forename: Antônio Jose
authors.initials: AJ
authors.lastname: Lagoeiro Jorge
authors.affiliation: Departamento de Clínica Médica, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brasil.
authors.forename: Wolney
authors.initials: W
authors.lastname: de Andrade Martins
authors.affiliation: Departamento de Clínica Médica, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brasil.
authors.forename: Evandro
authors.initials: E
authors.lastname: Tinoco Mesquita
authors.affiliation: Departamento de Clínica Médica, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brasil.
authors.forename: Monica
authors.initials: M
authors.lastname: Di Calafriori Freire
authors.affiliation: Departamento de Fundamentos de Enfermagem e Administração, Escola de Enfermagem Aurora de Afonso Costa, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brasil.
authors.forename: Dayse Mary
authors.initials: DM
authors.lastname: da Silva Correia
authors.affiliation: Departamento de Patologia, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brasil.
authors.forename: Hye Chung
authors.initials: HC
authors.lastname: Kang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000145:classification* / Q000209:etiology*; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D008171:Lung Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care
keywords: Bendopnea; Cuidados de saúde primários; Dispneia; Dispneia paroxística noturna; Dyspnea; Flexopneia; Heart failure; Insuficiência cardíaca; Paroxysmal nocturnal dyspnea; Primary care