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Original Research: DYSPNEA |

Repeated Breathlessness Experiences Induced by Hypercapnia: Differential Effects on Intensity and Unpleasantness

Li Wan, MD, PhD; Ilse Van Diest, PhD; Steven De Peuter, PhD; Katleen Bogaerts, PhD; Omer Van den Bergh, PhD
Author and Funding Information

*From the Department of Psychology, University of Leuven, Leuven, Belgium.

Correspondence to: Omer Van den Bergh, PhD, University of Leuven, Department of Psychology, Tiensestraat 102 Leuven B-3000, Belgium; e-mail: omer.vandenbergh@psy.kuleuven.be


The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2009;135(2):455-461. doi:10.1378/chest.08-1226
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Background:  The present study investigated the effect of repeated hypercapnic challenges on the sensory (intensity [I]) and affective (unpleasantness [U]) dimensions of breathlessness.

Methods:  Three subsequent rebreathing trials (Read, 1968) were administered to healthy men and women (n = 39). The I and U of breathlessness were rated every 20 s during the baseline, rebreathing, and recovery phases. Breathing behavior (fractional end-tidal CO2 [Fetco2] and minute ventilation [V̇e]) was monitored continuously. Intraindividual linear regression slopes for Fetco2 and V̇e] were calculated and standardized, separately for both rating dimensions.

Results:  Both the absolute magnitude and the slope of the I of breathlessness were higher compared to U (p < 0.05). Across-trial habituation of the peak I and U of breathlessness occurred in both genders (p < 0.001), but habituation was larger for the U than for the I (p = 0.05).

Conclusions:  The findings show that the sensory and affective dimensions of breathlessness can meaningfully be distinguished during hypercapnic challenges and that repeated exposures have different effects on both dimensions.

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