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Physiologic correlates of dyspnea in patients with morbid obesity.
Int J Obes (Lond). 2007 Apr; 31(4):700-6.IJ

Abstract

OBJECTIVE

Mechanisms of dyspnea in obesity remain unclear. This study was undertaken to determine the relationships between dyspnea and pulmonary function including inspiratory muscle endurance (IME) in morbidly obese patients before bariatric surgery.

RESEARCH METHODS AND PROCEDURES

Fifty-five patients with a mean+/-s.d. body mass index (BMI) of 49.4+/-7.0 kg/m(2) were included. Dyspnea was evaluated by the Baseline Dyspnea Index (BDI; 0-12, 0=maximal dyspnea). Pulmonary function tests included a plethysmography, maximal inspiratory pressure (PImax) and IME was assessed by the incremental threshold loading test, determining the maximal pressure sustained for 2 min (Plim(2)) and Plim(2)/PImax ratio. Patients were classified according to their BMI in two groups: BMI < or =49 (n=27) and >49 kg/m(2) (n=28).

RESULTS

Breathlessness was higher in the BMI >49 kg/m(2) group compared to the BMI < or =49 kg/m(2) group (BDI score at 6.9+/-2.2 in the BMI >49 kg/m(2) group vs 8.9+/-2.5 in the BMI < or =49 kg/m(2) group, P<0.01). Patients with BMI >49 kg/m(2) had significantly higher PaCO(2) level and significantly lower vital capacity, inspiratory capacity and PImax values compared with the BMI < or =49 kg/m(2) group. Correlations between BDI and lung function were moderate: forced expiratory volume in 1 s (FEV(1))% pred: Rho=0.27; P=0.05; vital capacity % pred: Rho=0.40; P=0.004; and Plim(2)/PImax: Rho=0.40; P=0.003. Higher correlations with dyspnea were found in the BMI < or =49 kg/m(2) group: FEV(1)% pred: Rho=0.38; P=0.05; and Plim(2)/PImax: Rho=0.49; P=0.01.

DISCUSSION

Inspiratory muscle performance is moderately reduced in morbid obesity. Dyspnea in these patients remains moderately related to lung function and inspiratory muscle performance. However, inspiratory muscles performance correlates more significantly with dyspnea in patients with a BMI < or =49 kg/m(2).

Authors+Show Affiliations

Lung Function Department, Calmette Hospital, Lille University, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17006440

Citation

Collet, F, et al. "Physiologic Correlates of Dyspnea in Patients With Morbid Obesity." International Journal of Obesity (2005), vol. 31, no. 4, 2007, pp. 700-6.
Collet F, Mallart A, Bervar JF, et al. Physiologic correlates of dyspnea in patients with morbid obesity. Int J Obes (Lond). 2007;31(4):700-6.
Collet, F., Mallart, A., Bervar, J. F., Bautin, N., Matran, R., Pattou, F., Romon, M., & Perez, T. (2007). Physiologic correlates of dyspnea in patients with morbid obesity. International Journal of Obesity (2005), 31(4), 700-6.
Collet F, et al. Physiologic Correlates of Dyspnea in Patients With Morbid Obesity. Int J Obes (Lond). 2007;31(4):700-6. PubMed PMID: 17006440.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Physiologic correlates of dyspnea in patients with morbid obesity. AU - Collet,F, AU - Mallart,A, AU - Bervar,J F, AU - Bautin,N, AU - Matran,R, AU - Pattou,F, AU - Romon,M, AU - Perez,T, Y1 - 2006/09/26/ PY - 2006/9/29/pubmed PY - 2007/11/14/medline PY - 2006/9/29/entrez SP - 700 EP - 6 JF - International journal of obesity (2005) JO - Int J Obes (Lond) VL - 31 IS - 4 N2 - OBJECTIVE: Mechanisms of dyspnea in obesity remain unclear. This study was undertaken to determine the relationships between dyspnea and pulmonary function including inspiratory muscle endurance (IME) in morbidly obese patients before bariatric surgery. RESEARCH METHODS AND PROCEDURES: Fifty-five patients with a mean+/-s.d. body mass index (BMI) of 49.4+/-7.0 kg/m(2) were included. Dyspnea was evaluated by the Baseline Dyspnea Index (BDI; 0-12, 0=maximal dyspnea). Pulmonary function tests included a plethysmography, maximal inspiratory pressure (PImax) and IME was assessed by the incremental threshold loading test, determining the maximal pressure sustained for 2 min (Plim(2)) and Plim(2)/PImax ratio. Patients were classified according to their BMI in two groups: BMI < or =49 (n=27) and >49 kg/m(2) (n=28). RESULTS: Breathlessness was higher in the BMI >49 kg/m(2) group compared to the BMI < or =49 kg/m(2) group (BDI score at 6.9+/-2.2 in the BMI >49 kg/m(2) group vs 8.9+/-2.5 in the BMI < or =49 kg/m(2) group, P<0.01). Patients with BMI >49 kg/m(2) had significantly higher PaCO(2) level and significantly lower vital capacity, inspiratory capacity and PImax values compared with the BMI < or =49 kg/m(2) group. Correlations between BDI and lung function were moderate: forced expiratory volume in 1 s (FEV(1))% pred: Rho=0.27; P=0.05; vital capacity % pred: Rho=0.40; P=0.004; and Plim(2)/PImax: Rho=0.40; P=0.003. Higher correlations with dyspnea were found in the BMI < or =49 kg/m(2) group: FEV(1)% pred: Rho=0.38; P=0.05; and Plim(2)/PImax: Rho=0.49; P=0.01. DISCUSSION: Inspiratory muscle performance is moderately reduced in morbid obesity. Dyspnea in these patients remains moderately related to lung function and inspiratory muscle performance. However, inspiratory muscles performance correlates more significantly with dyspnea in patients with a BMI < or =49 kg/m(2). SN - 0307-0565 UR - https://www.unboundmedicine.com/medline/citation/17006440/Physiologic_correlates_of_dyspnea_in_patients_with_morbid_obesity_ L2 - http://dx.doi.org/10.1038/sj.ijo.0803460 DB - PRIME DP - Unbound Medicine ER -