A common model for the breathlessness experience across cardiorespiratory disease

Area of Science:

• Cardiorespiratory Medicine
• Psychosomatic Medicine
• Data Science in Healthcare

Background:

• Chronic breathlessness is a prevalent and debilitating symptom in various cardiorespiratory conditions, often disproportionate to disease severity.
• Despite its link to adverse outcomes, breathlessness is infrequently targeted as an independent therapeutic goal.
• Existing research often focuses on single disease groups, limiting generalizability and understanding of shared underlying mechanisms.

Purpose of the Study:

• To identify and validate stable, underlying features (factors) contributing to the experience of chronic breathlessness across diverse cardiorespiratory diseases.
• To explore a data-driven, disease-independent approach for assessing the multifaceted nature of breathlessness.
• To establish a stable, compact set of measures for describing the breathlessness experience.

Main Methods:

• Exploratory Factor Analysis (EFA) was applied to questionnaire data from 182 participants with conditions including asthma, COPD, heart failure, and idiopathic pulmonary fibrosis.
• Participants were stratified based on their factor scores derived from the EFA.
• Model stability was assessed using 6-month follow-up data to confirm the robustness of identified factors.

Main Results:

• Four stable factors underlying the breathlessness experience were identified and labeled: body burden, affect/mood, breathing burden, and anger/frustration.
• Patient stratification based on these factor scores revealed two distinct groups: high and low burden.
• These burden groups were independent of the primary disease diagnosis and demonstrated stability over the 6-month follow-up period.

Conclusions:

• The study successfully identified and confirmed the stability of four key factors contributing to chronic breathlessness.
• These findings support the utility of disease-independent approaches for assessing breathlessness, moving beyond single-diagnosis frameworks.
• The identified factors provide a foundation for developing more targeted and effective therapeutic strategies for individuals experiencing chronic breathlessness.