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Published online before print September 13, 2006
Eur Respir J 2006, doi:10.1183/09031936.00045606
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ORIGINAL ARTICLE

Sex differences in thoracic adaptation to pulmonary hyperinflation in cystic fibrosis

F. Bellemare 1* A. Jeanneret 2

1 Laboratoire du sommeil
2 Département de pneumologie, Centre hospitalier de l'Université de Montréal (CHUM) - Hôtel-Dieu, 3840 St-Urbain, Montréal (Québec), Canada H2W1T8

* To whom correspondence should be addressed. E-mail: bellemaf{at}colba.net.


  Abstract

Sex differences in thoracic adaptation were reported in patients with cystic fibrosis (CF). We investigated the interplay between the pattern of thoracic adaptation and the function of the respiratory muscles in male and female CF patients with pulmonary hyperinflation.

Thoracic dimensions and diaphragm length were measured at residual volume, functional residual and total lung capacities using chest x-rays in 23 CF (12 males) and 18 normal subjects (11 males). Respiratory muscle recruitment during resting breathing was assessed by recording intra-thoracic and an intra-abdominal pressures.

In female CF patients rib cage expansion was predominant, tending to preserve diaphragm length. In male CF patients thoracic configuration was normal and diaphragm shortening consequently greater. Rib cage cross-section area for a given rib inclination was greater in CF patients indicating a structural expansion of the rib cage 2.5 times greater in females than males. The contribution of inspiratory rib cage muscles was also greater relative to the diaphragm in the CF group.

A structural expansion of the rib cage occurs in CF patients with lung hyperinflation that is greater in females than males and which is associated with an apparent greater contribution of inspiratory rib cage muscles to inspiratory pressure.

Keywords:  Chest wall, chest x-rays, diaphragm, gender, respiratory muscles




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