Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Andriopoulou Maria
Dissertation committee:
Γεώργιος Γκιόκας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αναστασία Κοτανίδου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Γεράσιμος Φιλιππάτος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Στυλιανός Ορφανός, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ιωάννης Βασιλειάδης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ελένη Μπουτάτη, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Νικολέτα Ροβίνα, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Υπερηχογραφική αξιολόγηση του διαφράγματος σε ασθενείς με καρδιακή ανεπάρκεια και διατηρημένο κλάσμα εξώθησης.
Translated title:
Ultrasonographic assessment of diaphragm in heart failure with preserved ejection fraction patients.
Summary:
Background: In patients with heart failure and preserved ejection fraction (HFpEF), exercise intolerance, measured by peak oxygen uptake (VO2), is a prognostic factor of morbidity. There is sparse information regarding skeletal muscles abnormalities and their relationship with exercise intolerance in these patients. Thus, we thought to investigate the difference of diaphragm function and quadriceps parameters measured by ultrasound, in HFpEF patients compared to healthy controls and the relation between the aforementioned parameters with exercise intolerance measured by peak VO2 uptake.
Methods: In this cross-sectional study, 25 patients with HFpEF and 25 matched controls were included. Ultrasound (US) assessment of diaphragm excursion during quiet (QBr) and deep breathing (DBr), rectus femoris cross-sectional area (RFcsa), quadriceps thickness (Qt) and cardiopulmonary exercise testing (CPET) were performed the same day for all participants.
Results: All US parameters and peak VO2 differ significantly between HFpEF patients and controls (p<0.05). The partial correlation coefficients among US parameters and peak VO2, after adjusting for group, age and gender revealed that greater peak VO2 was associated with higher Rfcsa (r=0.31, p=0.05), Qt (r=0.36, p<0.05), QBr (r=0.47, p<0.01), DBr (r=0.71, p<0.001) and reported dyspnea (RPD) (r=0.60, p<0.001). DBr was mostly associated with peak VO2 in total sample (p<0.001), in HFpEF (p=0.019) and control group (p<0.001) separately.
Conclusions: The high correlation of diaphragm and quadriceps muscle status with exercise intolerance supports the role of skeletal muscles in the pathophysiology of symptom generation in HFpEF patients, while diaphragmatic excursion during deep breathing is of higher importance.
Main subject category:
Health Sciences
Keywords:
Heart failure with preserved ejection fraction, Exercise intolerance, Fatigue, Diaphragm, Skeletal muscles
Number of references:
127
