Increased respiratory drive relates to severity of dyspnea in systemic sclerosis

BMC Pulmonary Medicine

Jan Stolk²  Annemie JM Schuerwegh¹  Willem BGJ Hamersma²  Maarten K Ninaber² 

[1] Rheumatology, Leiden University Medical Center, Leiden, the Netherlands;Department of Pulmonology (C3), Leiden University Medical Center, PO Box 9600, Leiden 2300RC, the Netherlands

关键词: Dyspnea evaluation;    Systemic sclerosis;    Respiratory drive;   

Others  :  863091
DOI  :  10.1186/1471-2466-14-57

 received in 2013-07-20, accepted in 2014-03-28,  发布年份 2014

【 摘 要 】

Background

Dyspnea may be a presenting symptom in progressive systemic sclerosis (SSc). Respiratory drive (mouth occlusion pressure, MOP, at rest and during CO₂ rebreathing, 7% CO₂, 93% O₂) is a major determinant of dyspnea and may relate to the magnitude of dyspnea.

Methods

In a prospective design, MOP at 0.1 sec (P0.1) was measured in 73 SSc patients while breathing room air and during CO₂ rebreathing. An abnormal V’E/P0.1 is defined as < 8 L/min/cm H₂O. Dyspnea scores were assessed by a shortness of breath questionnaire (UCSD dyspnea scale).

Results

Mean P0.1 in patients with normal V’E/P0.1 (n = 45) was 1.1 ± 0.04 and 1.6 ± 0.08 cm H₂O in patients with abnormal V’E/P0.1 (n = 28), p <0.001. ∆P0.1/∆PetCO₂ differed significantly between these groups (0.45 versus 0.75 cm H₂O/mmHg, P < 0.001), but no significant difference was present in ∆V’E/∆PetCO₂. V’E/P0.1 showed the highest significant correlation with the UCSD dyspnea score (r = -0.76, p <0.001). UCSD cut-off value for abnormal V’E/P0.1 was 8.5 (sensitivity 93%, specificity 96%, area under the curve 0.98).

Conclusions

In SSc patients an abnormal V’E/P0.1 better relates to the severity of dyspnea than traditional lung function parameters and can easily be assessed at first outpatient consultation.

【 授权许可】

   
2014 Ninaber et al.; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

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