AI Article Synopsis
- The study investigates diaphragm ultrasound as a tool to predict respiratory issues in patients with Duchenne muscular dystrophy (DMD), focusing on how diaphragm characteristics relate to pulmonary function.
- It analyzed data from 74 DMD patients, finding significant correlations between diaphragm thickening and excursion measurements and various factors like age, pulmonary capacity, and muscle strength.
- Results indicate that specific thresholds for diaphragm metrics can effectively predict restrictive respiratory patterns, suggesting potential clinical uses for ultrasound in monitoring respiratory health in DMD patients.
Article Abstract
Introduction/aims: Respiratory status is a key determinant of prognosis in patients with Duchenne muscular dystrophy (DMD). We aimed to evaluate the determinants of diaphragm ultrasound and its performance in predicting restrictive respiratory patterns in DMD.
Methods: This was a retrospective study of DMD patients followed in our center and admitted for an annual checkup from 2015 to 2018. We included DMD patients who underwent diaphragm ultrasound and pulmonary functional tests.
Results: This study included 74 patients with DMD. The right diaphragm thickening fraction (TF) was significantly associated with age (P = .001), Walton score (P = .012), inspiratory capacity (IC) (P = .004), upright forced vital capacity (FVC) (P < .0001), supine FVC (P = .038), and maximal inspiratory pressure (MIP) (P = .002). Right diaphragm excursion was significantly associated with age (P < .0001), steroid use (P = .008), history of spinal fusion (P < .0001), body mass index (BMI) (P = .002), Walton score (P < .0001), IC (P < .0001), upright FVC (P < .0001), supine FVC (P < .0001), and MIP (P < .0001). A right diaphragm TF >28% and a right diaphragm excursion>25.4 mm were associated with an FVC >50% with, respectively, an area under the curve (AUC) of 0.95 (P = .001) and 0.93 (P < .001). A left diaphragm TF >26.8% and a left diaphragm excursion >21.5 mm were associated with an FVC >50% with, respectively, an AUC of 0.95 (P = .011) and 0.97 (P < .001).
Discussion: Diaphragm excursion and diaphragm TF can predict restrictive pulmonary insufficiency in DMD.
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| http://dx.doi.org/10.1002/mus.27432 | DOI Listing |
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