The Importance of Measuring the Fraction of Diaphragmatic Thickening in Patients with COPD
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Abstract
Abstract
In addition to affecting the respiratory system, chronic obstructive pulmonary disease also decreases muscle mass. The respiratory muscles weaken, which impairs ventilation and exercise tolerance. According to recent studies, ultrasonography is a dependable and user-friendly method for determining the diaphragm thickening fraction (TFdi) in patients with COPD.
Objective: Evaluate the diaphragm thickening fraction by ultrasound in patients with COPD and correlate with different clinical, ventilatory variables, and the six-minute walking test.
Méthods: We conducted a prospective, observational study from 2021 to 2024. A total of Sixty-one consecutive patients with spirometry-confirmed stable COPD were included after obtaining informed written consent. Demographic and clinical data, spirometric values, the mMRC dyspnea score, the number of exacerbations, the COPD Assessment test (CAT), GOLD classification 2023, and the diaphragm thickening fraction (TFdi) were collected for analysis.
This is a prospective study conducted at Constantine Regional Military University Hospital.
Results: The mean of diaphragm thickening fraction, evaluated by ultrasound (Tfdi), in our patients with COPD was 48,9 ± 21.1%, The average BMI is 24.12 4.83 kg/m 2, with extreme values ranging from 14.6 to 36.9 kg/m 2, a positive correlation has been reported between Tfdi and the BMI (p = 0,003) a negative correlation has been reported between Tfdi and the dyspné MMRC, in our study, no objective correlation was found between TFdi and blood gas in our cohort, the average of FVC pré = 3,52 (L), FEV1 pré (L/s) ) 1,91, FEV1/FVC pré (%) = 53,57, a correlation between the Tfdi and spirometric data (FVC; FEV1; FEV1/FVC) was objectified, finally our study has shown that the more Tfdi increases, the distance patients travel increases (p = 0,001).
Conclusion: In patients with COPD, diaphragm thickening fraction (TFdi) appears to be associated with airway obstruction and BMI, 6-minute walking test as well as blood gas and perception of dyspnea.
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Redouan Belaala, Pulmonology Service, Constantine Regional Military University Hospital, Algeria
Pr belaala departement de medecine
Yacine Djeghri, Pulmonology Service, Constantine Regional Military University Hospital, Algeria
Pr djeghri departement medecin
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