PMID- 11476974
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 0928-4680 (Print)
IS  - 0928-4680 (Linking)
VI  - 8
IP  - 1
DP  - 2001 Aug
TI  - Diaphragmatic function in patients with chronic left ventricular failure.
PG  - 55-60
AB  - The aim of this paper is to evaluate the function of respiratory muscles 
      in-patients with chronic moderate left ventricular failure (LVF), and its 
      contribution to the pathophysiology of dyspnea and fatigue. We have studied 20 
      male patients with LVF, classes II and III of New York Heart Association (NYHA), 
      mean age 66.9+/-10 years (GI) and 19 male aged-matched controls without 
      cardiopulmonary disease mean age 64.6+/-8.4 years (GII). The evaluation included 
      (a) methods derived from volitional manoeuvres, maximal inspiratory pressures at 
      Functional Residual Capacity; maximal expiratory pressures at total lung capacity 
      (TLC); nasal sniff; oesophageal sniff and transdiaphragmatic pressures; (b) 
      methods derived from non-volitional manoeuvres, using bilateral cervical magnetic 
      stimulation of the phrenic nerves, measuring the following twitch pressures 
      (oesophageal, gastric and the transdiaphragmatic). With volitional manoeuvres we 
      have not found statistically significant differences between the two groups: 
      maximal expiratory pressures (cmH(2)O), GI 138+/-42; GII 152+/-40; P=NS and 
      maximal inspiratory pressures (cmH(2)O), GI 74.1+/-22; GII 85+/-16; P=NS. 
      However, these values were significantly lower than those obtained with sniff 
      manoeuvres, nasal sniff (cmH(2)O), GI 95.6+/-22; GII 99.6+/-16; P=NS and 
      oesophageal sniff (cmH(2)O), GI 96.2+/-20; GII 97.5+/-18; P=NS. There were no 
      significant differences between nasal sniff and oesophageal sniff. Using cervical 
      magnetic stimulation, we also didn't find a significant difference for 
      transdiaphragmatic twitch between groups, but the contribution of the diaphragm 
      to the transdiaphragmatic pressure was lower in patients with LVF since the 
      oesophageal twitch was lower (cmH(2)O), GI 11.4+/-3.4; GII 16.3+/-6.8; P<0,004. 
      In conclusion, the contribution of the diaphragm to total ventilation in-patients 
      with moderate LVF is preserved. However, its capacity to generate negative 
      intra-thoracic pressures is decreased since there is a significant decrease in 
      oesophageal twitch. So, it seems that the diaphragm is the first inspiratory 
      muscle to be affected in patients with moderate LVF.
FAU - Carmo, M M
AU  - Carmo MM
AD  - Departamento de Fisiopatologia da Faculdade de Ciencias Medicas de Lisboa, 
      Universidade Nova de Lisboa, Campo Santana, 130, 1198, Codex, Lisbon, Portugal
FAU - Barbara, C
AU  - Barbara C
FAU - Ferreira, T
AU  - Ferreira T
FAU - Branco, J
AU  - Branco J
FAU - Ferreira, S
AU  - Ferreira S
FAU - Rendas, A B
AU  - Rendas AB
LA  - eng
PT  - Journal Article
PL  - Switzerland
TA  - Pathophysiology
JT  - Pathophysiology : the official journal of the International Society for 
      Pathophysiology
JID - 9433813
EDAT- 2001/07/31 10:00
MHDA- 2001/07/31 10:01
CRDT- 2001/07/31 10:00
PHST- 2001/07/31 10:00 [pubmed]
PHST- 2001/07/31 10:01 [medline]
PHST- 2001/07/31 10:00 [entrez]
AID - S0928468001000657 [pii]
AID - 10.1016/s0928-4680(01)00065-7 [doi]
PST - ppublish
SO  - Pathophysiology. 2001 Aug;8(1):55-60. doi: 10.1016/s0928-4680(01)00065-7.