The dyspnoea-inactivity vicious circle in COPD: development and external validation of a conceptual model

Journal article


Ramon, Maria A., Riet, Gerben Ter, Carsin, Anne-Elie, Gimeno-Santos, Elena, Agustí, Alvar, Antó, Josep M., Donaire-Gonzalez, David, Ferrer, Jaume, Rodríguez, Esther, Rodriguez-Roisin, Robert, Puhan, Milo A., Garcia-Aymerich, Judith, PAC-COPD Study Group, and PAC-COPD Study Group. (2018). The dyspnoea-inactivity vicious circle in COPD: development and external validation of a conceptual model. European Respiratory Journal. 52(3), pp. 1 - 3. https://doi.org/10.1183/13993003.00079-2018
AuthorsRamon, Maria A., Riet, Gerben Ter, Carsin, Anne-Elie, Gimeno-Santos, Elena, Agustí, Alvar, Antó, Josep M., Donaire-Gonzalez, David, Ferrer, Jaume, Rodríguez, Esther, Rodriguez-Roisin, Robert, Puhan, Milo A., Garcia-Aymerich, Judith, PAC-COPD Study Group, and PAC-COPD Study Group
Abstract

The vicious circle of dyspnoea–inactivity has been proposed, but never validated empirically, to explain the clinical course of chronic obstructive pulmonary disease (COPD). We aimed to develop and validate externally a comprehensive vicious circle model. We utilised two methods. 1) Identification and validation of all published vicious circle models by a systematic literature search and fitting structural equation models to longitudinal data from the Spanish PAC-COPD (Phenotype and Course of COPD) cohort (n=210, mean age 68 years, mean forced expiratory volume in 1 s (FEV1) 54% predicted), testing both the hypothesised relationships between variables in the model (“paths”) and model fit. 2) Development of a new model and external validation using longitudinal data from the Swiss and Dutch ICE COLD ERIC (International Collaborative Effort on Chronic Obstructive Lung Disease: Exacerbation Risk Index Cohorts) cohort (n=226, mean age 66 years, mean FEV1 57% predicted). We identified nine vicious circle models for which structural equation models confirmed most hypothesised paths but showed inappropriate fit. In the new model, airflow limitation, hyperinflation, dyspnoea, physical activity, exercise capacity and COPD exacerbations remained related to other variables and model fit was appropriate. Fitting it to ICE COLD ERIC, all paths were replicated and model fit was appropriate. Previously published vicious circle models do not fully explain the vicious circle concept. We developed and externally validated a new comprehensive model that gives a more relevant role to exercise capacity and COPD exacerbations.

Year2018
JournalEuropean Respiratory Journal
Journal citation52 (3), pp. 1 - 3
PublisherEuropean Respiratory Society
ISSN0903-1936
Digital Object Identifier (DOI)https://doi.org/10.1183/13993003.00079-2018
Scopus EID2-s2.0-85056732761
Page range1 - 3
Research GroupMary MacKillop Institute for Health Research
Publisher's version
File Access Level
Controlled
Place of publicationUnited Kingdom
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Inspiratory capacity-to-total lung capacity ratio and dyspnoea predict exercise capacity decline in COPD
Ramon, Maria A., Ferrer, Jaume, Gimeno-Santos, Elena, Donaire-Gonzalez, David, Rodríguez, Esther, Balcells, Eva, de Batlle, Jordi, Benet, Marta, Guerra, Stefano, Sauleda, Jaume, Ferrer, Antoni, Farrero, Eva, Gea, Joaquim, Barberà, Joan A., Agustí, Àlvar, Rodriguez-Roisin, Robert, Antó, Josep M. and Garcia-Aymerich, Judith. (2016). Inspiratory capacity-to-total lung capacity ratio and dyspnoea predict exercise capacity decline in COPD. Respirology. 21(3), pp. 476 - 482. https://doi.org/10.1111/resp.12723
Characterisation and prognosis of undiagnosed chronic obstructive pulmonary disease patients at their first hospitalisation
Balcells, Eva, Gimeno-Santos, Elena, de Batlle, Jordi, Ramon, Maria Antonia, Rodríguez, Esther, Benet, Marta, Farrero, Eva, Ferrer, Antoni, Guerra, Stefano, Ferrer, Jaume, Sauleda, Jaume, Barberà, Joan A., Agustí, Àlvar, Rodriguez-Roisin, Robert, Gea, Joaquim, Antó, Josep M., Garcia-Aymerich, Judith, the, P. A. C. Copd Study Group and Donaire Gonzalez, David. (2015). Characterisation and prognosis of undiagnosed chronic obstructive pulmonary disease patients at their first hospitalisation. BMC Pulmonary Medicine. 15(1), p. Article 4. https://doi.org/10.1186/1471-2466-15-4
The added benefit of bicycle commuting on the regular amount of physical activity performed
Donaire-Gonzalez, David, de Nazelle, Audrey, Cole-Hunter, Tom, Curto, Ariadna, Rodríguez, Daniel A., Mendez, Michelle A., Garcia-Aymerich, Judith, Basagaña, Xavier, Ambros, Albert, Jerrett, Michael and Nieuwenhuijsen, Mark J.. (2015). The added benefit of bicycle commuting on the regular amount of physical activity performed. American Journal of Preventive Medicine. 49(6), pp. 842 - 849. https://doi.org/10.1016/j.amepre.2015.03.036
Objective correlates and determinants of bicycle commuting propensity in an urban environment
Cole-Hunter, Tom, Donaire-Gonzalez, David, Curto, A., Ambros, Albert, Valentín, Antònia, Garcia-Aymerich, J., Martínez, David, Braun, Lindsay M., Mendez, Michelle, Jerrett, Michael, Rodríguez, Daniel A., de Nazelle, Audrey and Nieuwenhuijsen, Mark J.. (2015). Objective correlates and determinants of bicycle commuting propensity in an urban environment. Transportation Research Part D. 40, pp. 132 - 143. https://doi.org/10.1016/j.trd.2015.07.004
Benefits of physical activity on COPD hospitalisation depend on intensity
Donaire-Gonzalez, David, Gimeno-Santos, Elena, Balcells, Eva, De Batlle, Jordi, Ramon, Maria A., Rodriguez, Esther, Farrero, Eva, Benet, Marta, Guerra, Stefano, Sauleda, Jaume, Ferrer, Antoni, Barberà, Joan A., Rodriguez-Roisin, Robert, Gea, Joaquim, Agusti, Alvar, Antó, Josep M., Garcia-Aymerich, Judith, PAC-COPD Study Group, , Ferrer, Jaume and PAC-COPD Study Group. (2015). Benefits of physical activity on COPD hospitalisation depend on intensity. European Respiratory Journal. 46(5), pp. 1281 - 1289. https://doi.org/10.1183/13993003.01699-2014
Positive health effects of the natural outdoor environment in typical populations in different regions in Europe (PHENOTYPE): A study programme protocol
Nieuwenhuijsen, Mark J., Kruize, Hanneke, Gidlow, Christopher, Andrusaityte, Sandra, Antó, Josep M., Basagaña, Xavier, Cirach, Marta, Dadvand, Payam, Danileviciute, Asta, Donaire-Gonzalez, David, Garcia, Judith, Jerrett, Michael, Jones, Marc V., Julvez, Jordi, van Kempen, Elise, van Kamp, Irene, Maas, Jolanda, Seto, Edmund, Smith, Graham, ... Gražulevičienė, Regina. (2014). Positive health effects of the natural outdoor environment in typical populations in different regions in Europe (PHENOTYPE): A study programme protocol. BMJ Open. 4(4), pp. 1 - 11. https://doi.org/10.1136/bmjopen-2014-004951
Lifetime occupational exposure to dusts, gases and fumes is associated with bronchitis symptoms and higher diffusion capacity in COPD patients
Rodríguez, Esther, Ferrer, Jaume, Zock, Jan-Paul, Serra, Ignasi, Antó, Josep M., De Batlle, Jordi, Kromhout, Hans, Vermeulen, Roel, Donaire-Gonzalez, David, Benet, Marta, Balcells, Eva, Monso, Eduard, Gayete, Angel, Garcia-Aymerich, J., Guerra, Stefano, Gea, Joaquim, Orozco-Levi, Mauricio, Vollmer, Ivan, Barberà, Joan A., ... Belda, José. (2014). Lifetime occupational exposure to dusts, gases and fumes is associated with bronchitis symptoms and higher diffusion capacity in COPD patients. PLoS ONE. 9(2), pp. 1 - 7. https://doi.org/10.1371/journal.pone.0088426
Using personal sensors to assess the exposome and acute health effects
Nieuwenhuijsen, Mark J., Donaire-Gonzalez, David, Foraster, Maria, Martínez, David and Cisneros, Andres. (2014). Using personal sensors to assess the exposome and acute health effects. International Journal of Environmental Research and Public Health. 11(8), pp. 7805 - 7819. https://doi.org/10.3390/ijerph110807805
Physical activity in COPD patients : Patterns and bouts
Donaire-Gonzalez, David, Gimeno-Santos, Elena, Balcells, Eva, Rodríguez, Diego A., Farrero, Eva, de Batlle, Jordi, Benet, Marta, Ferrer, Antoni, Barberà, Joan A., Gea, Joaquim, Rodriguez-Roisin, Robert, Antó, Josep M. and Garcia-Aymerich, Judith. (2013). Physical activity in COPD patients : Patterns and bouts. European Respiratory Journal. 42(4), pp. 993-1002. https://doi.org/10.1183/09031936.00101512
Comparison of physical activity measures using mobile phone-based calfit and actigraph
Donaire-Gonzalez, David, de Nazelle, Audrey, Seto, Edmund, Mendez, Michelle, Nieuwenhuijsen, Mark J. and Jerrett, Michael. (2013). Comparison of physical activity measures using mobile phone-based calfit and actigraph. Journal of Medical Internet Research. 15(6), p. e111. https://doi.org/10.2196/jmir.2470
Improving estimates of air pollution exposure through ubiquitous sensing technologies
de Nazelle, Audrey, Seto, Edmund, Donaire-Gonzalez, David, Mendez, Michelle, Matamala, Jaume, Nieuwenhuijsen, Mark J. and Jerrett, Michael. (2013). Improving estimates of air pollution exposure through ubiquitous sensing technologies. Environmental Pollution. 176, pp. 92 - 99. https://doi.org/10.1016/j.envpol.2012.12.032
Effect of bronchial colonisation on airway and systemic inflammation in stable COPD
Marin, Alicia, Garcia-Aymerich, Judith, Sauleda, Jaume, Belda, Jose, Millares, Laura, García-Núñez, Marian, Serra, Ignasi, Benet, Marta, Agustí, Alvar, Antó, Josep M., Monsó, Eduard, PAC-COPD Study Group and Donaire-Gonzalez, David. (2012). Effect of bronchial colonisation on airway and systemic inflammation in stable COPD. COPD. 9(2), pp. 121-130. https://doi.org/10.3109/15412555.2011.636407
Cured meat consumption increases risk of readmission in COPD patients
Jordi de Batlle, Mendez, Michelle, Romieu, Isabelle, Balcells, Eva, Benet, Marta, Donaire-Gonzalez, David, Ferrer, Jaume J., Orozco-Levi, Mauricio, Antó, Josep M., Garcia-Aymerich, Judith and PAC-COPD Study Group. (2012). Cured meat consumption increases risk of readmission in COPD patients. European Respiratory Journal. 40(3), pp. 555-560. https://doi.org/10.1183/09031936.00116911
Specific IgA and metalloproteinase activity in bronchial secretions from stable chronic obstructive pulmonary disease patients colonized by Haemophilus influenzae
Millares, Laura, Marin, Alicia, Garcia-Aymerich, J., Sauleda, Jaume, Belda, José, Monso, Eduard, Antó, Josep M., Benet, Marta, De Batlle, Jordi, Serra, Ignasi, Donaire Gonzalez, David, Guerra, Stefano, Gea, Joaquim, Balcells, Eva, Gayete, ADavidngel, Orozco-Levi, Mauricio, Vollmer, Ivan, Barberà, Joan A., Gomez, Federico P., ... Pallissa, Esther. (2012). Specific IgA and metalloproteinase activity in bronchial secretions from stable chronic obstructive pulmonary disease patients colonized by Haemophilus influenzae. Respiratory Research. 13(1). https://doi.org/10.1186/1465-9921-13-113
Validation of the Yale Physical Activity Survey in Chronic Obstructive Pulmonary Disease Patients
Donaire-Gonzalez, David, Gimeno-Santos, Elena, Serra, Ignasi, Roca, Josep, Balcells, Eva, Rodríguez, Esther, Farrero, Eva, Antó, Josep M. and Garcia-Aymerich, Judith. (2011). Validation of the Yale Physical Activity Survey in Chronic Obstructive Pulmonary Disease Patients. Archivos de Bronconeumología. 47(11), pp. 552-560.