RT Journal Article
SR Electronic
T1 Evolution of respiratory function in Duchenne muscular dystrophy from childhood to adulthood
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1701418
DO 10.1183/13993003.01418-2017
VO 51
IS 2
A1 Antonella LoMauro
A1 Marianna Romei
A1 Sandra Gandossini
A1 Riccardo Pascuzzo
A1 Simone Vantini
A1 Maria Grazia D'Angelo
A1 Andrea Aliverti
YR 2018
UL http://erj.ersjournals.com/content/51/2/1701418.abstract
AB In Duchenne muscular dystrophy (DMD), it is still to be determined if specific timepoints can be identified during the natural evolution of respiratory dysfunction from childhood to adulthood and if scoliosis, steroid therapy and nocturnal noninvasive mechanical ventilation (NIMV) have any effect on it.In a 7-year retrospective study performed on 115 DMD patients (6–24 years), evaluated once or twice per year, with 574 visits in total, evolution mean curves of spirometry, lung volumes, spontaneous breathing and thoraco-abdominal pattern (measured by optoelectronic plethysmography) parameters were obtained by nonlinear regression model analysis.While predicted values of forced vital capacity, forced expiratory volume in 1 s, and peak expiratory flow decline continuously since childhood, during spontaneous breathing the following parameters become significantly different than normal in sequence: abdominal contribution to tidal volume (lower after 14.8 years), tidal volume (lower after 17.2 years), minute ventilation (lower after 18.1 years) and respiratory rate (higher after 22.1 years). Restrictive lung pattern and diaphragmatic impairment are exacerbated by scoliosis severity, slowed by steroids treatment and significantly affected by NIMV.Spirometry, lung volumes, breathing pattern and thoraco-abdominal contributions show different evolution curves over time. Specific timepoints of respiratory impairment are identified during disease progression. These should be considered when defining outcome measures in clinical trials and treatment strategies in DMD.Specific time-points of diaphragmatic impairment are identified during DMD progression from childhood to adulthood http://ow.ly/YB2k30gNn4O