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Respiratory Research

, 8:18

First Online: 06 March 2007Received: 14 December 2006Accepted: 06 March 2007

Abstract

RationaleWe had shown that COPD women expressed more dyspnea than men for the same degree of airway obstruction.

ObjectivesEvaluate gender differences in respiratory factors associated with dyspnea in COPD patients.

MethodsIn a FEV1 % matched population of 100 men and women with COPD we measured: age, MMRC, FEV1, FVC, TLC, IC-TLC, PaO2, PaCO2, DLCO, Pimax, P0.1, Ti-Ttot, BMI, ffmi, 6MWD and VAS scale before and after the test, the Charlson score and the SGRQ. We estimated the association between these parameters and MMRC scores. Multivariate analysis determined the independent strength of those associations.

ResultsMMRC correlated with: BMI men:-0.29, p = 0.04; women:-0.28, p = 0.05, ffmi men:-0.39, p = 0.01, FEV1 % men:-0.64, p < 0.001; women:-0.29, p = 0.04, FVC % men:-0.45, p = 0.001; women:-0.33, p = 0.02, IC-TLC men:-0.52, p < 0.001; women: -0.27, p = 0.05, PaO2 men:-0.59, p < 0.001, PaCO2 men:0.27, p = 0.05, DLCO men:-0.54, p < 0.001, P0.1-Pimax men:0.46, p = 0.002; women:0.47, p = 0.005, dyspnea measured with the Visual Analog Scale before men:0.37, p = 0.04; women:0.52, p = 0.004 and after 6MWD men:0.52, p = 0.002; women:0.48, p = 0.004 and SGRQ total men:0.50, p < 0.001; women:0.59, p < 0.001. Regression analysis showed that P0.1-Pimax in women r = 0.30 and BMI, DLCO, PaO2 and P0.1-Pimax in men r = 0.81 were the strongest predictors of MMRC scores.

ConclusionIn mild to severe COPD patients attending a pulmonary clinic, P0.1-Pimax was the unique predictor of MMRC scores only in women. Respiratory factors explain most of the variations of MMRC scores in men but not in women. Factors other than the respiratory ones should be included in the evaluation of dyspnea in women with COPD.

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Autor: Juan P de Torres - Ciro Casanova - Angela Montejo de Garcini - Armando Aguirre-Jaime - Bartolome R Celli

Fuente: https://link.springer.com/







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