RT Journal Article
SR Electronic
T1 Thoraco-abdominal asynchronies during spontaneous breathing in Duchenne muscular dystrophy (DMD)
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1391
VO 40
IS Suppl 56
A1 Rita Priori
A1 Marianna Laviola
A1 Marianna Romei
A1 Antonella Lo Mauro
A1 Maria Grazia D'Angelo
A1 Andrea Aliverti
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/1391.abstract
AB Measurement of thoraco-abdominal asynchronies (TAA) is a useful tool to evaluate the action and control of the respiratory muscles. Whether studying asynchronous chest wall movements can give better insight into progressive impairment of respiratory muscle function in DMD is debated.We studied 100 DMD patients at different stages (mean age 14.1±5.8, range 4-32 yrs), subdivided into 4 age groups (G1<8(n=13), G2:8-12(n=27), G3:13-16(n=30), G4≥17(n=30) yrs) and 21 healthy age-matched male controls (CTR). Volume variations of chest wall compartments were measured during quiet breathing in supine position by opto-electronic plethysmography. Asynchronies between pulmonary rib cage(RCp) and abdomen(AB) were quantified in terms of phase shift between the relative compartmental volumes(VRCpvs.VAB).In all CTR subjects volume variations of AB led RCp (negative phase shifts, figure1) independently on age. A similar behavior was found in G1 DMD patients, but not in older subjects(G2, G3 and G4) where RCp was the leading compartments(p<0.05). With increasing age, the progressive changes in TAA were opposite between controls and DMD(p<0.01).In conclusion, in DMD patients lying supine the action of the inspiratory rib cage muscles progressively increases with age relative to the diaphragm. Accurate monitoring of TAA during spontaneous breathing is a valid indicator of diaphragm impairment and respiratory muscle dysfunction in DMD.