scholarly journals Evaluation of the relationship between the parameters of peripheral skeletal and respiratory muscles in patients with chronic obstructive pulmonary disease

2020 ◽  
Vol 92 (3) ◽  
pp. 36-41
Author(s):  
A. K. Suleymanova ◽  
I. A. Baranova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Respiratory Muscle ◽  
Respiratory Muscles ◽  
Chronic Obstructive ◽  
Muscle Dysfunction ◽  
Limb Muscle ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
The Relationship

Chronic obstructive pulmonary disease (COPD) is a group of diseases with high levels of comorbidity. Pathological changes of peripheral skeletal and respiratory muscles in COPD patients, which are often underestimated, occupy a special place. Aim. To study the relationship between functional and quantitative parameters of the peripheral (limb muscle) and respiratory muscles in COPD patients. Materials and methods. 127 patients (98 men/29 women, mean age 67.68.2 years) were under observation without acute COPD. All COPD patients were classified according to GOLD (2019) into groups A, B, C, D. The algorithm of the European Working Group on Sarcopenia in Older People (EWGSOP2) was used to diagnose sarcopenia. The muscle mass was measured using dual energy X-ray absorptiometry (DXA) and the appendicular lean mass index (ASM) was estimated. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured by body plethysmograph MasterScreen Body. Quantitative assessment of thoracic muscle cross-sectional areas were performed using the CT scan using Vidar Dicom Viewer software. Results. Sarcopenia was diagnosed in 43.3% of COPD patients. Respiratory muscle dysfunction was determined in 66.1% of patients with COPD, its probability increased in groups C and D in comparison with groups A and B [chance ratio 6.6 (95% confidence interval 2.915.0); p0.0001]. Correlations between the functional parameters of sarcopenia and respiratory muscle strength as well as between the mass of peripheral skeletal muscles and respiratory muscle area have been established according to the data of computerized tomography (р0.01). Sarcopenia as well as respiratory muscle dysfunction was observed more frequently in persons with severe and extremely severe airway obstruction and in patients with predominantly emphysematic COPD phenotype (p0.01). Conclusion. Sarcopenia is a frequent comorbidity in COPD and its development is connected with the severity of the course of the main disease. Correlation between parameters of peripheral (limb muscle) and respiratory muscles in patients with COPD has been determined.

scholarly journals EVALUATION OF CYTOKINE-MEDIATED MECHANISMS INVOLVED IN DEVELOPMENT OF RESPIRATORY MUSCLE DYSFUNCTION IN THE PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2019 ◽  
Vol 21 (3) ◽  
pp. 487-494
Author(s):  
E. P. Kalinina ◽  
B. I. Geltser ◽  
I. G. Kurpatov ◽  
T. V. Gorborukova ◽  
T. A. Gvozdenko
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Respiratory Muscle ◽  
Chronic Obstructive ◽  
Muscle Dysfunction ◽  
Moderate Increase ◽  
Clustering Methods ◽  
Obstructive Pulmonary Disease ◽  
Immune Parameters ◽  
Copd Patients

Respiratory muscle (RM) strength was studied in 85 men with exacerbations of chronic obstructive pulmonary disease (COPD). The strength indicators of expiratory (MEP) and inspiratory pressure (MIP, SNIP) in oral cavity were registered by means of the MicroRPM device (CareFusion, UK), as well as intranasal pressure levels by SNIP test. The measured MEP, MIP и SNIP values were compared to the proper indices. Serum concentrations of cytokines (IL-4, IL-6, IL-10, IL-17A, IL-21, TNFα, IFNγ and TGF-β) were determined. The results of the study were processed by means of canonical analysis and by clustering methods. Expiratory RM dysfunction was recorded in mild COPD, expiratory-inspiratory RM dysfunction was recorded in moderate COPD and the diaphragm dysfunction was recorded in severe COPD. Three groups of patients with different combinations of RM strength indicators and immune parameters were identified by means of cluster analysis. The cytokine profile in the first cluster was characterized by maximal concentrations of IL-17A, IL-21, TNFα and TGF-β, whereas RM strength indexes showed minimal values. In the second cluster, a decrease of RM strength indicators by 25-40% against control was associated with a sharp rise of IL-6, along with moderate increase of IL-21 and TGF-βconcentrations. In the third cluster, maximal levels of IL-6, IL-10 and IFNγwere registered, along with low levels of IL-17A, IL-21 and TGF-β concentrations, whereas MEP, MIP и SNIP values did not sufficiently differ from their levels in second cluster. The results of canonical and correlation analysis indicated to interconnections between either certain cytokines, or their pool with the RM strength indicators, dyspnea severity and functional state of COPD patients, thus suggesting involvement of cytokine-mediated mechanisms in pathogenesis of the respiratory muscle dysfunction.

scholarly journals Functional State of Respiratory Muscles in Patients with Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 99 (6) ◽  
pp. 15-21
Author(s):  
I. G. Kurpаtov ◽  
B. I. Geltser ◽  
V. N. Kotelnikov ◽  
M. F. Kinyaykin
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Respiratory Muscle ◽  
Respiratory Muscles ◽  
Strength Characteristics ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Muscle Dysfunction ◽  
Obstructive Pulmonary Disease

The objective: to assess the strength of respiratory muscles (RM) in patients with chronic obstructive pulmonary disease (COPD) and determine the role of certain pathogenetic factors of COPD in the development of respiratory muscle dysfunction.Subjects and methods. In in-patient settings, the strength characteristics of respiratory muscles were studied in 85 men aged 39-78 years suffering fromCOPD exacerbation. MicroRPM (CareFusion, UK) was used to determine the levels of maximum inspiratory and expiratory pressures in the oral cavity, maximum rate of their rise during inspiration and expiration as well as the level of intranasal pressure before and after the test with salbutamol.Results. Significant variability in strength characteristics of respiratory muscles was observed depending on the stage of COPD, its phenotype, and the presence of hypoxemia or hypercapnia. In patients at early stage of COPD, only expiratory respiratory muscle dysfunction was documented; at moderate and severe stages, inspiratory and expiratory muscle dysfunction was observed, and at very severe stage – diaphragm dysfunction prevailed. The results of the salbutamol test demonstrated the maximum increase in the strength of respiratory in early and moderate COPD and the minimum increase in extremely severeCOPD indicating the role of the irreversible component of bronchial obstruction in the development of respiratory muscle dysfunction. The emphysematous phenotype of COPD was characterized by inspiratory respiratory muscle dysfunction, while the bronchitic phenotype was characterized by expiratory respiratory muscle dysfunction. In patients with hypoxemia and hypercapnia, the strength of inspiratory respiratory muscle was lower versus normoxemia.

Non-invasive Assessment of Respiratory Muscle Function and its Relationship to Exercise Tolerance in Patients with Chronic Obstructive Pulmonary Disease

2006 ◽  
Vol 34 (3) ◽  
pp. 240-246 ◽  
Author(s):  
J Chlumský ◽  
P Filipova ◽  
M Terl
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Muscle Function ◽  
Exercise Tolerance ◽  
Respiratory Muscle ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Non Invasive ◽  
Respiratory Muscle Function ◽  
Copd Patients

Most patients with chronic obstructive pulmonary disease (COPD) have impaired respiratory muscle function. Maximal oesophageal pressure correlates closely with exercise tolerance and seems to predict the distance walked during the 6-min walk test. This study assessed the non-invasive parameters of respiratory muscle function in 41 patients with COPD to investigate their relationship to pulmonary function tests and exercise tolerance. The COPD patients, who demonstrated the full range of airway obstruction severity, had a mean forced expiratory volume in 1 s of 42.5% predicted (range, 20–79% predicted). Both the maximal inspiratory muscle strength and non-invasive tension-time index were significantly correlated with the degree of lung hyperinflation, as expressed by the ratio of residual volume to total lung capacity, and the distance walked in 6 min. We conclude that respiratory muscle function was influenced mainly by lung hyperinflation and that it had an important effect on exercise tolerance in COPD patients.

scholarly journals Role of Type2 Inflammatory Biomarkers in Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 9 (8) ◽  
pp. 2670
Author(s):  
Keiji Oishi ◽  
Kazuto Matsunaga ◽  
Toshihiro Shirai ◽  
Keita Hirai ◽  
Yasuhiro Gon
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Stable State ◽  
Epidemiologic Studies ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Blood Eosinophils ◽  
The Relationship

Airway inflammation in chronic obstructive pulmonary disease (COPD) is typically thought to be driven by Type1 immune responses, while Type2 inflammation appears to be present in definite proportions in the stable state and during exacerbations. In fact, some COPD patients showed gene expression of Type2 inflammation in the airway, and this subset was associated with the inhaled corticosteroid (ICS) response. Interestingly enough, the relationship between COPD and diseases associated with Type2 inflammation from the perspective of impaired lung development is increasingly highlighted by recent epidemiologic studies on the origin of COPD. Therefore, many researchers have shown an interest in the prevalence and the role of existent Type2 biomarkers such as sputum and blood eosinophils, exhaled nitric oxide fraction, and atopy, not only in asthma but also in COPD. Although the evidence about Type2 biomarkers in COPD is inconsistent and less robust, Type2 biomarkers have shown some potential when analyzing various clinical outcomes or therapeutic response to ICS. In this article, we review the existent and emerging Type2 biomarkers with clinically higher applicability in the management of COPD.

scholarly journals Relationship between Vitamin D Level and Serum TNF-α Concentration on the Severity of Chronic Obstructive Pulmonary Disease

2019 ◽  
Vol 7 (14) ◽  
pp. 2298-2304
Author(s):  
Muhammad Ilyas ◽  
Agussalim Agussalim ◽  
Megawati Megawati ◽  
Nasrum Massi ◽  
Irawaty Djaharuddin ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Vitamin D ◽  
Airway Obstruction ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Vitamin D Levels ◽  
Tnf Α ◽  
The Relationship

Background: Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory disease and disturbed bacterial clearance. Vitamin D deficiency is sometimes observed in COPD patients and as significant roles in increasing inflammation of airway obstruction and systemic obstruction, increasing proinflammatory cytokine including TNF-α, reduction of bacterial clearance and increase exacerbation risk due to infection. Also, vitamin D plays significant roles in the metabolism of calcium and mineralization of bones and regulation system of immune. TNF-α also has essential roles in pathogenesis and inflammation of COPD.  Several studies that investigate the relationship between vitamin D level and serum TNF-α concentration in COPD patients are relatively uncommon, including in Indonesia. For that reason, this study aimed to assess the relationship between vitamin D level and TNF-α concentration in patients on the severity of the chronic obstructive pulmonary disease. Methods This study was a hospital-based descriptive cross-sectional study. Total samples were 50 COPD patients with the average age of older than 60 years during their enrollments at the Department of Pulmonology and Respiratory Medicine of the Dr.Wahidin Sudirohusodo General hospital  Makassar in September 2018-January 2019. All procedures of the present study were reviewed and approved by the Research Ethics Committee of Medicine Faculty of Hasanuddin University. The severity of COPD was assessed according to the combination of COPD assessment stages that referred to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guideline 2015 that consisted of the combination of scoring COPD Assessment Test (CAT), the modified Medical Research Council (mMRC) questionnaire and results of the spirometric measurement. Assessment of airway obstruction levels referred to the GOLD spirometric criteria. Determination of thoracic photographs was conducted to verify the COPD diagnosis of the severity of COPD. Determination of serum TNF-α concentration and vitamin D3 [1,25(OH)2D3] level used the ELISA method. Results  The majority of COPD patients were observed in the category of older than 60 years old accounted for 34 COPD patients (68%), and the majority of COPD patients were males accounted for 47 males with COPD (94%). The majority of COPD patients were observed in the group of D (38%). All the study subjects observed in this study were smokers, and 82% of them were in the category of heavy smokers. 21 study subjects had higher concentration of serum TNF-α  (tertile 3 = 0.21-1.83 pg/dl), 20 study subjects  and lower level of vitamin D (tertile 1 = 182.1-364.5 pg/dl). The majority of the study subjects (38%) were in the category of severe COPD (category D of the severity of COPD at the tertile 3) according to the GOLD Combine Assessment. In view of the relationship between vitamin D level and serum TNF-α concentration on the airway obstruction, there were significant positive correlations between the increase of vitamin D levels and the increase of serum TNF-α concentrations on airway obstruction. In view of the relationship between vitamin D level and serum TNF-α concentration on the severity of COPD, there were significant positive correlations between the increase of vitamin D levels (tertiles 1, 2 and 3) and the increase of serum TNF-α concentrations on the severity of COPD at p-value<0.05. Overall, there were non-linear relationships between vitamin D level and serum TNF-α concentration on the severity of COPD. Conclusions: Serum TNF-α concentration was positively associated with airway obstruction level and severity of COPD. Low level of vitamin D was negatively associated with airway obstruction level and severity of COPD. Vitamin D3 level (1,25(OH)2D) was negatively associated with serum TNF-α concentration and airway obstruction level and severity of COPD.

scholarly journals Chronic obstructive pulmonary disease and cardiovascular comorbidity

Kardiologiia ◽  
2019 ◽  
Vol 59 (8S) ◽  
pp. 24-36 ◽  
Author(s):  
Z. R. Aisanov ◽  
A. G. Chuchalin ◽  
E. N. Kalmanova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
General Population ◽  
Pulmonary Disease ◽  
Point Of View ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Obstructive Pulmonary Disease ◽  
Cardiovascular Comorbidity ◽  
Copd Patients ◽  
The Relationship

In recent years, a greater understanding of the heterogeneity and complexity of chronic obstructive pulmonary disease (COPD) has come from the point of view of an integrated clinical assessment of severity, pathophysiology, and the relationship with other pathologies. A typical COPD patient suffers on average 4 or more concomitant diseases and every day about a third of patients take from 5 to 10 different drugs. The mechanisms of the interaction of COPD and cardiovascular disease (CVD) include the effects of systemic inflammation, hyperinflation (hyperinflation) of the lungs and bronchial obstruction. The risk of developing CVD in patients with COPD is on average 2–3 times higher than in people of a comparable age in the general population, even taking into account the risk of smoking. The prevalence of coronary heart disease, heart failure, and rhythm disturbances among COPD patients is significantly higher than in the general population. The article discusses in detail the safety of prescribing various groups of drugs for the treatment of CVD in patients with COPD. Achieving success in understanding and managing patients with COPD and CVD is possible using an integrated multidisciplinary approach.

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