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Title: Breathing–swallowing discoordination is associated with frequent exacerbations of COPD
Authors: Nagami, Shinsuke
Oku, Yoshitaka
Yagi, Naomi
Sato, Susumu  kyouindb  KAKEN_id  orcid (unconfirmed)
Uozumi, Ryuji  kyouindb  KAKEN_id  orcid (unconfirmed)
Morita, Satoshi
Yamagata, Yoshie
Kayashita, Jun
Tanimura, Kazuya
Sato, Atsuyasu  kyouindb  KAKEN_id
Takahashi, Ryosuke  kyouindb  KAKEN_id
Muro, Shigeo
Author's alias: 永見, 慎輔
八木, 直美
佐藤, 晋
魚住, 龍史
森田, 智視
谷村, 和哉
佐藤, 篤靖
髙橋, 良輔
室, 繁郎
Issue Date: 1-Jun-2017
Publisher: BMJ Publishing Group
Journal title: BMJ Open Respiratory Research
Volume: 4
Issue: 1
Thesis number: e000202
Abstract: [Introduction] Impaired coordination between breathing and swallowing (breathing–swallowing discoordination) may be a significant risk factor for the exacerbation of chronic obstructive pulmonary disease (COPD). We examined breathing–swallowing discoordination in patients with COPD using a noninvasive and quantitative technique and determined its association with COPD exacerbation. [Methods] We recruited 65 stable outpatients with COPD who were enrolled in our prospective observational cohort study and did not manifest an apparent swallowing disorder. COPD exacerbation was monitored for 1 year before and 1 year after recruitment. Swallowing during inspiration (the I-SW pattern) and swallowing immediately followed by inspiration (the SW-I pattern) were identified. [Results] The mean frequency of the I-SW and/or SW-I patterns (I-SW/SW-I rate) was 21.5%±25.5%. During the 2-year observation period, 48 exacerbation incidents (25 patients) were identified. The I-SW/SW-I rate was significantly associated with the frequency of exacerbation. During the year following recruitment, patients with a higher I-SW/SW-I frequency using thicker test foods exhibited a significantly higher probability of future exacerbations (p=0.002, log-rank test). [Conclusions] Breathing–swallowing discoordination is strongly associated with frequent exacerbations of COPD. Strategies that identify and improve breathing– swallowing coordination may be a new therapeutic treatment for patients with COPD.
Rights: © Article author(s). This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
DOI(Published Version): 10.1136/bmjresp-2017-000202
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