BACKGROUND: The potential role of decreased respiratory muscle mass, if any, in mediating the susceptibility to exacerbation in COPD patients has not been determined. We hypothesized that a decrease in respiratory muscle mass is associated with increased risk of multiple hospital admissions due to acute exacerbations of the disease. METHODS: Eligible cases and controls (n=20) were identified from records of our department's pulmonary clinic. Ten subjects diagnosed with COPD (males, 66+/-7yr, Body Mass Index (BMI)=26+/-4kg/m(2)) were identified as fragile patients. Fragility was defined as four or more admissions in the previous year due to severe exacerbations of the disease. Fragile patients were matched with 10 non-fragile controls, defined as COPD patients who had required only one admission due to exacerbation of the disease. Criteria for 1:1 matching included ethnicity, gender, age, BMI, degree of airflow obstruction (i.e., FEV(1)), comorbidity and chronic treatment. Multiple computed tomography (CT) scan slices were obtained to assess area and attenuation coefficients of multiple upper limb, thorax, abdomen and lower limb muscles. RESULTS: CSA of intercostal and abdominal muscles was significantly decreased in fragile COPD patients (right side intercostals, mean relative difference (MRD)=-14%, p=0.010; OR (95% CI)=2.2 (1.1-4.8), p=0.021; left side, MRD=-13%, p=0.007; OR=2.2 (1.1-4.5), p=0.027). CSA and attenuation coefficients of all other muscle compartments showed no statistical differences between the two study groups but showed the same trend. Strength of the inspiratory and expiratory muscles did not differ between the two study groups. CONCLUSIONS: This study shows that the risk for multiple admissions due to a COPD exacerbation associates with a marked decrease in the CSA of the intercostal muscle compartment. Copyright 2009 Elsevier Ltd. All rights reserved.
BACKGROUND: The potential role of decreased respiratory muscle mass, if any, in mediating the susceptibility to exacerbation in COPDpatients has not been determined. We hypothesized that a decrease in respiratory muscle mass is associated with increased risk of multiple hospital admissions due to acute exacerbations of the disease. METHODS: Eligible cases and controls (n=20) were identified from records of our department's pulmonary clinic. Ten subjects diagnosed with COPD (males, 66+/-7yr, Body Mass Index (BMI)=26+/-4kg/m(2)) were identified as fragilepatients. Fragility was defined as four or more admissions in the previous year due to severe exacerbations of the disease. Fragilepatients were matched with 10 non-fragile controls, defined as COPDpatients who had required only one admission due to exacerbation of the disease. Criteria for 1:1 matching included ethnicity, gender, age, BMI, degree of airflow obstruction (i.e., FEV(1)), comorbidity and chronic treatment. Multiple computed tomography (CT) scan slices were obtained to assess area and attenuation coefficients of multiple upper limb, thorax, abdomen and lower limb muscles. RESULTS: CSA of intercostal and abdominal muscles was significantly decreased in fragile COPDpatients (right side intercostals, mean relative difference (MRD)=-14%, p=0.010; OR (95% CI)=2.2 (1.1-4.8), p=0.021; left side, MRD=-13%, p=0.007; OR=2.2 (1.1-4.5), p=0.027). CSA and attenuation coefficients of all other muscle compartments showed no statistical differences between the two study groups but showed the same trend. Strength of the inspiratory and expiratory muscles did not differ between the two study groups. CONCLUSIONS: This study shows that the risk for multiple admissions due to a COPD exacerbation associates with a marked decrease in the CSA of the intercostal muscle compartment. Copyright 2009 Elsevier Ltd. All rights reserved.
Authors: Jamie S Sheth; Meng Xia; Susan Murray; Carlos H Martinez; Catherine A Meldrum; Elizabeth A Belloli; Margaret L Salisbury; Eric S White; Colin H Holtze; Kevin R Flaherty Journal: Respir Med Date: 2019-01-24 Impact factor: 3.415
Authors: Merry-Lynn N McDonald; Alejandro A Diaz; Erica Rutten; Sharon M Lutz; Rola Harmouche; Raul San Jose Estepar; Greg Kinney; John E Hokanson; Barbara A Gower; Emiel F M Wouters; Stephen I Rennard; Craig P Hersh; Richard Casaburi; Mark T Dransfield; Edwin K Silverman; George R Washko Journal: Eur Respir J Date: 2017-12-14 Impact factor: 16.671
Authors: Peter Wallbridge; Selina M Parry; Sourav Das; Candice Law; Gary Hammerschlag; Louis Irving; Mark Hew; Daniel Steinfort Journal: Sci Rep Date: 2018-10-15 Impact factor: 4.379
Authors: Karin J C Sanders; Juliette H R J Degens; Anne-Marie C Dingemans; Annemie M W J Schols Journal: Int J Chron Obstruct Pulmon Dis Date: 2019-04-03
Authors: Merry-Lynn N McDonald; Alejandro A Diaz; James C Ross; Raul San Jose Estepar; Linfu Zhou; Elizabeth A Regan; Eric Eckbo; Nina Muralidhar; Carolyn E Come; Michael H Cho; Craig P Hersh; Christoph Lange; Emiel Wouters; Richard H Casaburi; Harvey O Coxson; William Macnee; Stephen I Rennard; David A Lomas; Alvar Agusti; Bartolome R Celli; Jennifer L Black-Shinn; Greg L Kinney; Sharon M Lutz; John E Hokanson; Edwin K Silverman; George R Washko Journal: Ann Am Thorac Soc Date: 2014-03