Diaphragm Muscle Dysfunction in Patients With Heart Failure
Diaphragm Muscle Dysfunction in Patients With Heart Failure
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DOI：
10.1016/j.cardfail.2017.12.004
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发表时间：
2018-04-01
影响因子：
6
通讯作者：
Yamamoto, Kazuhiro
中科院分区：
文献类型：
--
作者：
Miyagi, Mari;Kinugasa, Yoshiharu;Yamamoto, Kazuhiro
背景：吸气肌无力与心力衰竭（HF）患者运动不耐受的发生有关。超声评估膈肌用于评估呼吸肌功能，但其在HF患者中的应用仍不明确。我们研究了膈肌功能的关系，通过超声检查与吸气肌力和运动耐量在HF.Methods和结果：77例HF住院患者进行了评估。膈肌功能受损定义为吸气末膈肌厚度小于4.0 mm的中值，这代表膈肌损失和收缩减少。与膈肌功能保留的患者相比，膈肌功能受损的患者年龄更大;肺活量、握力和最大吸气压评估的吸气肌力显著更低; 6分钟步行距离显著更短（6 MWD; P <0.05）。虽然低握力也与短6 MWD，膈肌功能受损和短6 MWD之间的关系是独立的年龄，肺活量，和握力strength.Conclusion：膈肌功能障碍超声评估代表吸气肌无力，并预测运动不耐受独立的共病肺功能障碍和动力性心力衰竭患者。
Background: Inspiratory muscle weakness is associated with the development of exercise intolerance in patients with heart failure (HF). Ultrasound assessment of the diaphragm is used to evaluate respiratory muscle function, but its application in patients with HF remains undefined. We examined the relationship of diaphragm function as assessed by ultrasonography with inspiratory muscle strength and exercise tolerance in HF.Methods and Results: Seventy-seven patients hospitalized with HF were enrolled. Impaired diaphragm muscle function was defined as a diaphragm thickness at end-inspiration of less than the median value of 4.0 mm, which represents diaphragm muscle loss and reduced contraction. Compared with patients with preserved diaphragm muscle function, those with impaired diaphragm muscle function were older; had significantly lower vital capacity, handgrip strength, and inspiratory muscle strength as assessed by the maximum inspiratory pressure; and had a significantly shorter 6-minute walk distance (6MWD; P < .05). Although low handgrip strength was also associated with a short 6MWD, the relationship between impaired diaphragm muscle function and short 6MWD was independent from age, vital capacity, and handgrip strength.Conclusion: Diaphragm dysfunction as assessed by ultrasonography represents inspiratory muscle weakness and predicts exercise intolerance independently from comorbid pulmonary dysfunction and dynapenia in patients with HF.