TY - JOUR T1 - Effects of cardiomegaly on regional chest wall volume in patients with chronic Chagas cardiomyopathy JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p2112 AU - Joao Danyell Silva AU - Daniella Brandao AU - Jasiel Nascimento, Jr. AU - Larissa Carvalho AU - Wilson Oliveira Junior AU - Raquel Britto AU - Guilherme Fregonezi AU - Andrea Aliverti AU - Armele Dornelas de Andrade Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p2112.abstract N2 - Heart failure is commonly related to changes in breathing pattern in order to evaluate the specific effects of cardiomegaly on chest wall function in Chronic Chagas Cardiomyopathy (CCC) we studied 12 CCC patients with cardiomegaly ejection fraction (EF) of left ventricle < 45% of predicted value; age 57.08±8.52 years; body mass index (BMI) 24.63±4.83 kg/m2) and 5 CCC patients without cardiomegaly (EF > 45; 68.8±6.83 years; 32.92±7.69 kg/m2). Maximal inspiratory pressure (MIP) and chest wall volume by Opto-Electronic Plethysmography (OEP) were measured. OEP data were acquired during quite breathing (QB) and inspiratory loaded breathes (ILB) with threshold set at 50% of MIP.During QB, patients with cardiomegaly showed lower percentage contributions to tidal volume of both pulmonary rib cage (VRCp%) (p=0.01) and abdominal rib cage (VRCa%) (p=0,02) compared to patients without cardiomegaly. During ILB, VRCa% (p=0.03), end-inspiratory (p=0.03) and end-expiratory (p=0.04) volumes of abdominal rib cage volume were reduced compared to patients without cardiomegaly. In conclusion, increased heart size within thoracic cavity affects chest wall function in the rib cage compartments. The lower rib cage displacement is affected especially during inspiratory efforts. This mechanical constraint leads to a restrictive breathing pattern, which is related to high elastic load to both inspiration and expiration. ER -