P2625Pathophysiology of diaphragm involvement in systolic heart failure: insights from diaphragm ultrasound and phrenic nerve stimulation studies
Abstract Background Diaphragm ultrasound allows for assessment of both diaphragm excursion and thickness. Cervical and cortical magnetic stimulation (CEMS and COMS) with recording of the diaphragmatic compound motor action potential (CMAP) is diagnostically useful to evaluate the conductive properti...
Gespeichert in:
| Veröffentlicht in: | European heart journal 2019-10, Vol.40 (Supplement_1) |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | Supplement_1 |
| container_start_page | |
| container_title | European heart journal |
| container_volume | 40 |
| creator | Spiesshoefer, J Tuleta, I T Giannoni, A G Boentert, M B |
| description | Abstract
Background
Diaphragm ultrasound allows for assessment of both diaphragm excursion and thickness. Cervical and cortical magnetic stimulation (CEMS and COMS) with recording of the diaphragmatic compound motor action potential (CMAP) is diagnostically useful to evaluate the conductive properties of the inspiratory pathway. Systolic heart failure (HF) is characterized by a loss of systolic pump function. Diaphragm weakness in HF has been reported to potentially contribute to exercise intolerance
Methods
14 patients with systolic HF (11 men, 3 women; 64±12 years, NYHA 2±0.9, LVEF 36.1±5.6%) and 12 healthy controls matched for age and gender (4 men, 8 women; 56±8 years) underwent spirometric lung function testing and assessment of diaphragm excursion (during tidal breathing, TB, voluntary sniff, VS and deep breathing, DB) and thickness of the right hemidiaphragm by ultrasound. COMS and CEMS of the phrenic nerves with simultaneous bilateral recording of the diaphragm CMAP using surface electrodes was performed in 9 patients.
Results
Compared to controls, HF patients showed reduced forced vital capacity (75.46±18.05% vs. 107.62±17.13%, p |
| doi_str_mv | 10.1093/eurheartj/ehz748.0948 |
| format | Article |
| fullrecord | <record><control><sourceid>oup_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1093_eurheartj_ehz748_0948</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/eurheartj/ehz748.0948</oup_id><sourcerecordid>10.1093/eurheartj/ehz748.0948</sourcerecordid><originalsourceid>FETCH-LOGICAL-c878-8f3ec7a9ade5b9a065955855e4cf7d19f4823d62fbaf72c2a5825f8b2a20474b3</originalsourceid><addsrcrecordid>eNqNkNFKwzAUhoMoOKePIOQFuqVpkybeyVAnDNzFLrwrp22yZrRNSdJBfQvf2M6JeOnF4RzO4fsPfAjdx2QRE5ks1eBqBS4clqr-yFKxIDIVF2gWM0ojyVN2iWYkliziXLxfoxvvD4QQwWM-Q59byinbQqhtX4_e2MbuR2w1rgz0tYN9i013tM1RtaoL04z96INtTIm_f2INphmcephO3uzr4LF2tv2DD01w4O3QVRimmraqm-hOuaPCPph2aCAYOwWHoTLK36IrDY1Xdz99jnbPT7vVOtq8vbyuHjdRKTIRCZ2oMgMJlWKFBMKZZEwwptJSZ1UsdSpoUnGqC9AZLSkwQZkWBQVK0iwtkjli59jSWe-d0nnvTAtuzGOSn7Tmv1rzs9b8pHXiyJmzQ_9P5AuGCoVO</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>P2625Pathophysiology of diaphragm involvement in systolic heart failure: insights from diaphragm ultrasound and phrenic nerve stimulation studies</title><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Spiesshoefer, J ; Tuleta, I T ; Giannoni, A G ; Boentert, M B</creator><creatorcontrib>Spiesshoefer, J ; Tuleta, I T ; Giannoni, A G ; Boentert, M B</creatorcontrib><description>Abstract
Background
Diaphragm ultrasound allows for assessment of both diaphragm excursion and thickness. Cervical and cortical magnetic stimulation (CEMS and COMS) with recording of the diaphragmatic compound motor action potential (CMAP) is diagnostically useful to evaluate the conductive properties of the inspiratory pathway. Systolic heart failure (HF) is characterized by a loss of systolic pump function. Diaphragm weakness in HF has been reported to potentially contribute to exercise intolerance
Methods
14 patients with systolic HF (11 men, 3 women; 64±12 years, NYHA 2±0.9, LVEF 36.1±5.6%) and 12 healthy controls matched for age and gender (4 men, 8 women; 56±8 years) underwent spirometric lung function testing and assessment of diaphragm excursion (during tidal breathing, TB, voluntary sniff, VS and deep breathing, DB) and thickness of the right hemidiaphragm by ultrasound. COMS and CEMS of the phrenic nerves with simultaneous bilateral recording of the diaphragm CMAP using surface electrodes was performed in 9 patients.
Results
Compared to controls, HF patients showed reduced forced vital capacity (75.46±18.05% vs. 107.62±17.13%, p<0.05). Diaphragm excursion amplitude was significantly reduced in HF patients (4.29±1.35 cm vs. 7.34±2.10 cm, p<0.05). Diaphragm contractility was impaired too, as reflected by the diaphragm thickening ratio (DTR; 2.01±0.46 vs. 2.53±0.74, p<0.05). Diaphragm CMAP following COMS and CEMS of the phrenic nerves revealed normal latencies in HF patients compared to controls (COMS Latency; 19.05±2.37 msec vs. 18.97±3.59 msec, p= n. s.).
Conclusions
Diaphragm involvement in systolic HF is reflected by reduced FVC and impaired ultrasound parameters of diaphragm function. Diaphragmatic pathology is likely to be myopathic because magnetic phrenic nerve conduction studies show no abnormalities. Diaphragm ultrasound may be useful as a diagnostic tool for assessment of diaphragm function in systolic HF.
Acknowledgement/Funding
This study was supported by Sanofi-Genzyme, Neu-Isenburg, Germany. The funders had no role in study design, data collection and analysis, preparation.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehz748.0948</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>European heart journal, 2019-10, Vol.40 (Supplement_1)</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com. 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,1585,27929,27930</link.rule.ids></links><search><creatorcontrib>Spiesshoefer, J</creatorcontrib><creatorcontrib>Tuleta, I T</creatorcontrib><creatorcontrib>Giannoni, A G</creatorcontrib><creatorcontrib>Boentert, M B</creatorcontrib><title>P2625Pathophysiology of diaphragm involvement in systolic heart failure: insights from diaphragm ultrasound and phrenic nerve stimulation studies</title><title>European heart journal</title><description>Abstract
Background
Diaphragm ultrasound allows for assessment of both diaphragm excursion and thickness. Cervical and cortical magnetic stimulation (CEMS and COMS) with recording of the diaphragmatic compound motor action potential (CMAP) is diagnostically useful to evaluate the conductive properties of the inspiratory pathway. Systolic heart failure (HF) is characterized by a loss of systolic pump function. Diaphragm weakness in HF has been reported to potentially contribute to exercise intolerance
Methods
14 patients with systolic HF (11 men, 3 women; 64±12 years, NYHA 2±0.9, LVEF 36.1±5.6%) and 12 healthy controls matched for age and gender (4 men, 8 women; 56±8 years) underwent spirometric lung function testing and assessment of diaphragm excursion (during tidal breathing, TB, voluntary sniff, VS and deep breathing, DB) and thickness of the right hemidiaphragm by ultrasound. COMS and CEMS of the phrenic nerves with simultaneous bilateral recording of the diaphragm CMAP using surface electrodes was performed in 9 patients.
Results
Compared to controls, HF patients showed reduced forced vital capacity (75.46±18.05% vs. 107.62±17.13%, p<0.05). Diaphragm excursion amplitude was significantly reduced in HF patients (4.29±1.35 cm vs. 7.34±2.10 cm, p<0.05). Diaphragm contractility was impaired too, as reflected by the diaphragm thickening ratio (DTR; 2.01±0.46 vs. 2.53±0.74, p<0.05). Diaphragm CMAP following COMS and CEMS of the phrenic nerves revealed normal latencies in HF patients compared to controls (COMS Latency; 19.05±2.37 msec vs. 18.97±3.59 msec, p= n. s.).
Conclusions
Diaphragm involvement in systolic HF is reflected by reduced FVC and impaired ultrasound parameters of diaphragm function. Diaphragmatic pathology is likely to be myopathic because magnetic phrenic nerve conduction studies show no abnormalities. Diaphragm ultrasound may be useful as a diagnostic tool for assessment of diaphragm function in systolic HF.
Acknowledgement/Funding
This study was supported by Sanofi-Genzyme, Neu-Isenburg, Germany. The funders had no role in study design, data collection and analysis, preparation.</description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqNkNFKwzAUhoMoOKePIOQFuqVpkybeyVAnDNzFLrwrp22yZrRNSdJBfQvf2M6JeOnF4RzO4fsPfAjdx2QRE5ks1eBqBS4clqr-yFKxIDIVF2gWM0ojyVN2iWYkliziXLxfoxvvD4QQwWM-Q59byinbQqhtX4_e2MbuR2w1rgz0tYN9i013tM1RtaoL04z96INtTIm_f2INphmcephO3uzr4LF2tv2DD01w4O3QVRimmraqm-hOuaPCPph2aCAYOwWHoTLK36IrDY1Xdz99jnbPT7vVOtq8vbyuHjdRKTIRCZ2oMgMJlWKFBMKZZEwwptJSZ1UsdSpoUnGqC9AZLSkwQZkWBQVK0iwtkjli59jSWe-d0nnvTAtuzGOSn7Tmv1rzs9b8pHXiyJmzQ_9P5AuGCoVO</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Spiesshoefer, J</creator><creator>Tuleta, I T</creator><creator>Giannoni, A G</creator><creator>Boentert, M B</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20191001</creationdate><title>P2625Pathophysiology of diaphragm involvement in systolic heart failure: insights from diaphragm ultrasound and phrenic nerve stimulation studies</title><author>Spiesshoefer, J ; Tuleta, I T ; Giannoni, A G ; Boentert, M B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c878-8f3ec7a9ade5b9a065955855e4cf7d19f4823d62fbaf72c2a5825f8b2a20474b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Spiesshoefer, J</creatorcontrib><creatorcontrib>Tuleta, I T</creatorcontrib><creatorcontrib>Giannoni, A G</creatorcontrib><creatorcontrib>Boentert, M B</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Spiesshoefer, J</au><au>Tuleta, I T</au><au>Giannoni, A G</au><au>Boentert, M B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>P2625Pathophysiology of diaphragm involvement in systolic heart failure: insights from diaphragm ultrasound and phrenic nerve stimulation studies</atitle><jtitle>European heart journal</jtitle><date>2019-10-01</date><risdate>2019</risdate><volume>40</volume><issue>Supplement_1</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Abstract
Background
Diaphragm ultrasound allows for assessment of both diaphragm excursion and thickness. Cervical and cortical magnetic stimulation (CEMS and COMS) with recording of the diaphragmatic compound motor action potential (CMAP) is diagnostically useful to evaluate the conductive properties of the inspiratory pathway. Systolic heart failure (HF) is characterized by a loss of systolic pump function. Diaphragm weakness in HF has been reported to potentially contribute to exercise intolerance
Methods
14 patients with systolic HF (11 men, 3 women; 64±12 years, NYHA 2±0.9, LVEF 36.1±5.6%) and 12 healthy controls matched for age and gender (4 men, 8 women; 56±8 years) underwent spirometric lung function testing and assessment of diaphragm excursion (during tidal breathing, TB, voluntary sniff, VS and deep breathing, DB) and thickness of the right hemidiaphragm by ultrasound. COMS and CEMS of the phrenic nerves with simultaneous bilateral recording of the diaphragm CMAP using surface electrodes was performed in 9 patients.
Results
Compared to controls, HF patients showed reduced forced vital capacity (75.46±18.05% vs. 107.62±17.13%, p<0.05). Diaphragm excursion amplitude was significantly reduced in HF patients (4.29±1.35 cm vs. 7.34±2.10 cm, p<0.05). Diaphragm contractility was impaired too, as reflected by the diaphragm thickening ratio (DTR; 2.01±0.46 vs. 2.53±0.74, p<0.05). Diaphragm CMAP following COMS and CEMS of the phrenic nerves revealed normal latencies in HF patients compared to controls (COMS Latency; 19.05±2.37 msec vs. 18.97±3.59 msec, p= n. s.).
Conclusions
Diaphragm involvement in systolic HF is reflected by reduced FVC and impaired ultrasound parameters of diaphragm function. Diaphragmatic pathology is likely to be myopathic because magnetic phrenic nerve conduction studies show no abnormalities. Diaphragm ultrasound may be useful as a diagnostic tool for assessment of diaphragm function in systolic HF.
Acknowledgement/Funding
This study was supported by Sanofi-Genzyme, Neu-Isenburg, Germany. The funders had no role in study design, data collection and analysis, preparation.</abstract><pub>Oxford University Press</pub><doi>10.1093/eurheartj/ehz748.0948</doi></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0195-668X |
| ispartof | European heart journal, 2019-10, Vol.40 (Supplement_1) |
| issn | 0195-668X 1522-9645 |
| language | eng |
| recordid | cdi_crossref_primary_10_1093_eurheartj_ehz748_0948 |
| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| title | P2625Pathophysiology of diaphragm involvement in systolic heart failure: insights from diaphragm ultrasound and phrenic nerve stimulation studies |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-14T07%3A51%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-oup_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=P2625Pathophysiology%20of%20diaphragm%20involvement%20in%20systolic%20heart%20failure:%20insights%20from%20diaphragm%20ultrasound%20and%20phrenic%20nerve%20stimulation%20studies&rft.jtitle=European%20heart%20journal&rft.au=Spiesshoefer,%20J&rft.date=2019-10-01&rft.volume=40&rft.issue=Supplement_1&rft.issn=0195-668X&rft.eissn=1522-9645&rft_id=info:doi/10.1093/eurheartj/ehz748.0948&rft_dat=%3Coup_cross%3E10.1093/eurheartj/ehz748.0948%3C/oup_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/&rft_oup_id=10.1093/eurheartj/ehz748.0948&rfr_iscdi=true |