Objective To evaluate the diagnostic value of brain natriuretic peptide (BNP) for cardiac dyspnea.Methods Plasma BNP levels were measured by radioimmunoassay in dyspnea patients with chronic heart failure (CHF) (n=52) or without CHF (n=30) and normal control group (n=28).Results The BNP level in dyspnea patients with CHF was significantly higher than that of dyspnea patients without CHF and normal control group [(649.80±141.72) pg/mL vs (59.08±18.60) pg/mL and (65.20±16.32) pg/mL，respectively,Plt;0.05].There was no significant difference of BNP level between dyspnea patients without CHF and normal group (Pgt;0.05).The plasma BNP level elevated with the worsening of heart failure (NYHA Classiffication).The BNP level in dyspnea patients with CHF was negatively correlated with left ventricle ejection fraction (r=－0.673，Plt;0.001).The receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve (AUC) is 0.91(0.88-0.98，Plt;0.001) with a sensitivity of 87.2% and a specificity of 86.8% at the cutoff value of 206 pg/mL.Conclusion Measurement of plasma BNP is a rapid diagnostic method for cardiac dyspnea.
ObjectiveTo systematically review the methodological quality and measurement properties of dyspnea assessment tools for chronic obstructive pulmonary disease (COPD) patients based on the consensus-based standards for the selection of health measurement instruments (COSMIN) guidelines, and provide evidence for clinicians in selecting the optimal assessment tool. MethodsComputerized searches were conducted in PubMed, Web of Science, Embase, CNKI, VIP, and Wanfang databases for studies related to dyspnea assessment tools in COPD patients, from the establishment of each database until April 2024. Two researchers independently screened and extracted data according to the inclusion and exclusion criteria. The included assessment tools were evaluated based on the COSMIN guidelines, and final recommendations for the tools were formulated. ResultsA total of 18 studies were included, involving 14 dyspnea assessment tools for COPD patients. The following tools were recommended as Grade A: SOBDA, PFSDQ-M, Chinese version of Dyspnoea-12, Norwegian version of Dyspnoea-12, and RSQ. Grade B recommendations included the Chinese version of the revised PFSDQ, SOBQ-UCSD version, S-CRQ, CRQ-SR, C-MRADLQ, and BCSS. Grade C recommendations included the Arabic version of Dyspnoea-12, Chinese version of COPD-MSD, and C-SOBQ. ConclusionThe scales SOBDA, PFSDQ-M, Chinese version of Dyspnoea-12, Norwegian version of Dyspnoea-12, and RSQ have been comprehensively evaluated across various measurement properties and demonstrate good reliability and validity. Considering the national context in China, the Chinese version of Dyspnoea-12 is tentatively recommended, though other measurement properties still require further validation.
ObjectiveTo investigate the effects of pulmonary rehabilitation on the exercise capacity and quality of life in patients with stable chronic obstructive pulmonary disease (COPD) for a optimal strategy for pulmonary rehabilitation.
MethodsOne hundred and six patients with COPD in stable stage were divided into group B (n=37), group C (n=36), and group D(n=33) based on GOLD 2011.Each group of patients were randomly subdivided into a control group(usual care), a pulmonary rehabilitation strategy group 1 (breathing training), and a pulmonary rehabilitation strategy group 2 (breathing training and exercise training), and they were intervened for 24 weeks.Pulmonary function(FEV1%pred), COPD Assessment Test (CAT), modified British Medical Research Council dyspnea scale(mMRC), BODE index and 6-minute walking distance(6MWD) were compared before and after intervention.
ResultsAfter pulmonary rehabilitation intervening for 24 weeks, in group B and group C, pulmonary rehabilitation strategy group 2 showed the best effect, CAT, mMRC, BODE index, and 6MWD were proved significantly different before and after pulmonary rehabilitation (P < 0.05).In group D, all indexes had no significant difference between pulmonary rehabilitation strategy group 1 and group 2 before and after pulmonary rehabilitation (P > 0.05), but they were better than those of the control group.Correlation analysis showed that CAT score had significant correlation with FEV1 % pred, mMRC, BODE index and 6MWD (P < 0.01).
ConclusionPatients with different subgroup of COPD based on GOLD 2011 may take different pulmonary rehabilitation strategies to achieve the optimal effect.
