Biological Psychology 25 (1987) 73-92

North-Holland

73

ABSTRACTS OF PAPERS PRESENTED AT THE SIXTH INTERNATIONAL SYMPOSIUM ON RESPIRATORY PSYCHOPHYSIOLOGY, LONDON, 18-19 SEPTEMBER 1986

Edited by

Jennifer J. ALWEN and Rachel M. ROSSER

Academic Department of Psychiatry, The Middlesex Hospital, London WIN 8AA, U. K

Accepted for publication 1 June 1987

1. INTRODUCTION

The Sixth International Symposium on Respiratory Psychophysiology was held at the University College and Middlesex School of Medicine on the 18th and 19th September 1986. Both oral presentations and posters provided lively discussion. We decided to invite papers on any topic, rather than on specific themes, and it was thus possible to identify the problems which more groups are choosing to investigate. Looking back on earlier meetings a clear change can be discerned in the focus of research. The early interest in asthma has diminished, featuring in only one presentation. Hyperventilation has replaced it as the topic of principal concern accounting for more than half the submissions. Several groups continue to report on basic physiological research, focussing mainly on normal subjects, but also on those with chest pain and spinal cord lesions. Technical research seems to have a less prominent position than hitherto, with only two papers, both from the Oxford group. Chronic obstructive airways disease, a condition which is said to be becoming less common, remains the main interest of a small group of researchers.

From the discussion it became clear that these meetings have served overtly to focus research activity in a few scientifically productive and clinically important areas. While this is the best formula for achieving real progress there is a question about whether the balance is right. For example, not a single paper was submitted on the measurement of breathlessness and yet it is unclear that the available instruments are satisfactory. Furthermore, despite the interest in hyperventilation, only one group reported on a trial of treat- ment for this condition. The only randomised controlled trial of treatment reported was for chronic obstructive airways disease, one of the most treat- ment-resistant conditions!

0301-0511/87/$3.50 0 1987, Elsevier Science Publishers B.V. (North-Holland)

74 J.J. Aiwen and R.M. Rawer, Eds. / Abstructs

A balance between basic science and clinical application characterised work in asthma presented in earlier symposia and occupying several groups world wide in the previous four decades. It is to be hoped that as more information is gathered about the physiological and biochemical mechanisms underlying normal and disordered breathing, there will be some shift back to rigorous research on treatments for other common conditions.

Rachel Rosser

2. ABSTRACTS

HYPERVENTILATION IN PATIENTS ADMITTED TO THE CORONARY CARE UNIT

Leisa J. FREEMAN, Jenny C. KING and P.G.F. NIXON Cardmc Department, Charmg Cross Hospital, London W6 8RF. U.K.

Sixty nine patients who were admitted consecutively to a coronary care unit over a three-month period with a diagnosis of chest pain (infarction?) and who had survived for five days were studied. Symptoms suggesting hyperventilation were sought using the Nijmegen HV questionnaire. Hyperventilation is consid- ered likely with a score of 30 or more. Fifty one patients were found not to have sustained a myocardial infarction of whom 38 (74.5%) were considered to hyperventilate (mean score of 44). Eighteen patients had evidence of myocar- dial infarction (ECG and enzymes) of whom six (33.3%) had a score greater than 30. All patients with myocardial infarction then underwent forced hyperventilation provocation testing (FHVPT) and a modified Bruce Protocol exercise test with Pet CO, monitoring two weeks following discharge. Four patients had resting hypocapnia (< 30 mmHg) and seven reproduced re- cognisable symptoms following HVPT; this was typical chest pain in four. Eight patients had a delayed rate of return of Pet CO, to baseline levels (Beumer & Hardonk slope > 1.5). During an initial 3-min warm-up period on the treadmill at 1 mph, 14 (77.7%) patients demonstrated a dip of Pet CO, to less than 30 mmHg for at least 1 min or more; thereafter the results were more variable and will be presented. Hyperventilation appears increasingly to be of importance in the assessment of cardiac patients.