For example, difficulty in bending over could be due to musculoskeletal or other problems rather than to dyspnea. Firstly, the questionnaire is highly subjective and does not allow for an objective analysis of the symptoms analyzed. However, the study has certain limitations that should be borne in mind. Interestingly, they also reported significant associations with depression and diabetes, a finding that merits more detailed investigation. The authors concluded that bendopnea was the only form of dyspnea not associated with chronic obstructive pulmonary disease (COPD), but that it was associated with HF, particularly HF with preserved ejection fraction (HFpEF). 5 The study included 633 randomly selected individuals aged 45-99 years who completed a questionnaire and underwent clinical assessment, laboratory testing, electrocardiography and echocardiography. analyze the association between different forms of dyspnea and chronic non-communicable diseases, particularly cardiopulmonary disease, in primary health care. In their study published in this issue of the Journal, Martinez Cerón et al. 2 In functional studies using cardiopulmonary exercise testing, bendopnea was associated with elevated VE/VCO 2. 3 It also appears to be related to short-term mortality. 2 Some authors consider that it may be a valuable marker for early identification of decompensated HF. It is even more common (48.8%) in patients with decompensated HF, with either reduced or preserved ejection fraction. Pathophysiologically, the condition appears to be linked to positional increase in left and right ventricular filling pressures in patients whose baseline pressures are already elevated 1 (although it is not clear whether intrathoracic or intra-abdominal pressures are involved), and generally appears within 30 s of bending over. 1 The investigation of bendopnea in this study was based on an objective assessment, in which the patient adopted the appropriate position in the presence of an investigator, and the symptom was identified in 28% of individuals. analyzed the frequency of this symptom in patients with HF with left ventricular systolic dysfunction (HF with reduced ejection fraction ) referred for cardiac catheterization. 1,2 In their original description of bendopnea, published in 2014, Thibodeau et al. Orthopnea is more directly associated with increased filling pressures and is thus much more specific. Exertional dyspnea is also found in other conditions, particularly respiratory disease, and is thus a moderately sensitive but relatively nonspecific marker of HF. It frequently occurs when performing everyday actions such as tying shoelaces or putting on socks.ĭyspnea in its various forms (exertional dyspnea, orthopnea and paroxysmal nocturnal dyspnea) is a major and extremely common symptom in HF. Bendopnea is a symptom of heart failure (HF) recently described by Thibodeau et al., 1 characterized by difficulty in breathing when leaning over.
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