The Relationship between Diaphragmatic Movements in Sonographic Assessment and Disease Severity in Patients with Stable Chronic Obstructive Pulmonary Disease (COPD)

Introduction: Pulmonary hyperinflation in patients with chronic obstructive pulmonary disease (COPD) can increase the breathing rate and reduce diaphragmatic movements by pushing the diaphragms downward and limiting their movements; this, in fact, can affect the breathing process. The purpose of this study was to compare diaphragmatic movements in COPD patients and healthy ones and to evaluate the relation of diaphragmatic movements and COPD severity in patients. Materials and Methods: This cross- sectional study was performed in Ghaem hospital,Mashhad Iran. Twenty-five COPD patients (case group) were selected, based on the inclusion and exclusion criteria. The patients’ demographic and clinical characteristics along with factors related to pulmonary function were recorded. Patients were referred for sonography after pulmonary evaluation. The status of the left portal vein or one of its branches at the end of a deep expiration and a deep inspiration was considered as a marker. Twenty-five healthy non-smoker subjects, who were matched with the patients in terms of age and sex, were studied as the control group for the comparison of sonographic findings of the diaphragms. Results: The current study included 25 healthy subjects and 25 COPD patients, with the mean age of 59.2±12 years; approximately 84% of the subjects were males. Evaluation of the rate of diaphragmatic movements by sonography showed the mean of 42.08±12.15mm and 73.28±15.19mm in the case and control groups, respectively, which showed a statistically significant difference between them (P=0.02). Statistical analysis indicated the relationship between the rate of diaphragmatic movements with factors related to airway obstruction. However, no relationship was observed between the rate of diaphragmatic movements and the factors associated with pulmonary hyperinflation or air retention. Conclusion: The rate of diaphragmatic movements as a parameter for determining exercise capacity in COPD patients could help with a better understanding of activity limitations in these patients