Respiratory Function In Patients Research Articles

Impact of nasal high-flow humidified oxygen therapy on oxygenation index and respiratory function in patients with Stanford Type B aortic dissection and hypoxemia

Impact of nasal high-flow humidified oxygen therapy on oxygenation index and respiratory function in patients with Stanford Type B aortic dissection and hypoxemia

The effectiveness of vaccination against pneumococcal infection in patients with severe bronchial asthma

The article discusses topical issues of the use of conjugated 13-valent pneumococcal vaccine Prevenar®13 (PCV13) in patients with severe bronchial asthma (SBA), including those receiving targeted therapy with genetically engineered biological drugs (GEBD). To study the effectiveness of vaccination against pneumococcal infection (PI) in patients with SBA. The study included 381 patients with SBA. The average age in the study groups was 45.5 (42.0; 52.5) years. All patients underwent clinical and instrumental studies, including spirography with bronchodilation test. After confirming the diagnosis of BA, the patients were divided into 2 observation groups. Group 1 (n=191) consisted of patients undergoing treatment with GEBD. Group 2 included patients with asthma receiving standard therapy, according to the 4th-5th stage according to the criteria of the Global Initiative for Asthma 2022 (Global Initiative for Asthma - GINA). The observation group consisted of 190 patients. In each group, there are subgroups of patients who have been vaccinated against PI and have not been vaccinated for various reasons. The following criteria were used as the main endpoints of observation for 12 months to assess the effectiveness: the number of pneumonia during the observation period, the number of exacerbations of asthma (severe, non-severe), the number of hospitalizations, the duration of exacerbations, the level of control according to the Asthma Control Questionnaire (ACQ5), functional indicators. The coverage of PI vaccination in patients with BA remains quite low, further organizational and methodological work is required to increase their involvement in vaccination. Immunization of PCV13 in patients with SBA at the 4th-5th stage of therapy reduces the risk of community-acquired pneumonia by at least 28.5%. PCV13 vaccination may be an additional effective tool for controlling the symptoms of SBA, including in patients undergoing treatment with GEBD. Vaccination allows to normalize the functional parameters of respiratory function in patients with SBA. PCV13 is well tolerated and does not cause any significant allergic reactions in patients with asthma. PCV13 vaccination is an effective tool for reducing the risk of community-acquired pneumonia in patients with severe bronchial asthma, including those on targeted therapy with genetically engineered biological drugs.

The Effect of Exercise on Improving Respiratory Function and Physical Activity in Hospitalized Patients with COVID-19

Background: The outbreak of COVID-19 has been associated with various physical and psychological effects. The role of exercise in strengthening the immune system and reducing inflammation has already been proven. Moderate levels of exercise can enhance overall immunity. Exercise can improve intracellular metabolism and increase cell defense activity by improving inflammatory cytokines, immature B cells, and cytotoxic T cells. Therefore, exercise is known as a defense strategy against respiratory infections. Here the role of exercise in improving respiratory function and physical activity in hospitalized patients with COVID-19 was evaluated. Methods: The present study was performed as a randomized clinical trial on 90 hospitalized patients with COVID-19. Both groups received all routine treatments (medication, invasive or non-invasive ventilation, physiotherapy). Then, in the experimental group, standard exercises were provided to improve the patients’ physical condition and exercise capacity. After two weeks and one month later, all indices were measured again in two groups. Results: The results of the present study showed that exercise causes significant changes in indicators such as 6-Minute Walk Test (6MWT) (p=0.001), balance score (p=0.02), and Sf1 score (p=0.05) in two time periods before and after rehabilitation in two groups. Conclusion: Performing standard and defined exercise exercises for patients with the new coronavirus improves the physical activity and respiratory function of patients.

The efficacy and safety of dual orexin receptor antagonists in obstructive sleep apnea: A systematic review and meta-analysis of randomised controlled trials.

Dual orexin receptor antagonists (DORAs) are indicated for the treatment of insomnia disorder. However, DORAs may change sleep parameters, thus having adverse effects on patients with obstructive sleep apnea (OSA). This meta-analysis clarified the impact of DORAs in OSA treatment on sleep architecture and respiratory parameters. We systematically searched PubMed, Embase, and Cochrane Central databases for randomised control trials published up to May 2024. The search focussed on studies discussing the effects of DORAs on sleep architecture in patients with OSA. Nonrandomised studies were excluded. A meta-analysis using a random-effects model was performed. The patients were categorised into subgroups based on the treatment protocol (single or multiple dosages). The Cochrane risk of bias tool for randomised trials assessed the risk of bias. Our meta-analysis included four randomised placebo-controlled trials, encompassing 126 patients with a mean age of 49.1 years. The effects of DORAs on sleep architecture and respiratory parameters were examined. The main findings were as follows: DORAs significantly increased the total sleep time and improved sleep efficiency. However, they did not affect rapid eye movement sleep. DORAs also showed a trend towards decreased wake after sleep onset and did not increase the apnea-hypopnea index. DORAs did not increase the percentage of total sleep time with oxygen saturation lower than 90% and 85% compared with placebo, respectively. Furthermore, DORAs were not associated with significantly higher adverse effects compared with placebo. This meta-analysis demonstrated that DORAs improve sleep and do not impair nighttime respiratory function in patients with OSA.

Switching treatment to cipaglucosidase alfa plus miglustat positively affects patient-reported outcome measures in patients with late-onset Pompe disease

BackgroundLate-onset Pompe disease (LOPD), a rare autosomal recessive multisystemic disorder, substantially impacts patients’ day-to-day activities, outcomes, and health-related quality of life (HRQoL). The PROPEL trial compared cipaglucosidase alfa plus miglustat (cipa+mig) with alglucosidase alfa plus placebo (alg+pbo) in adult patients with LOPD over 52 weeks and showed improved motor and respiratory function in patients switching treatment from standard-of-care enzyme replacement therapy (ERT) to cipa+mig at baseline. This study evaluated the impact of cipa+mig on patient-reported outcomes (PROs), including HRQoL in ERT-experienced patients, using data from PROPEL.MethodsPROs evaluated included the Subject’s Global Impression of Change (SGIC), Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Short Form 20a, PROMIS Fatigue Short Form 8a, Rasch-built Pompe-specific Activity (R-PAct), and European Quality of Life-5 Dimensions 5 Response Levels (EQ-5D-5L). The proportions of responders in the cipa+mig arm and the alg+pbo arm were compared via chi-squared or Fisher’s exact test (patient-level responder analysis), and least squares (LS) mean differences were calculated for change from baseline at Week 52 of the PRO measures (group-level analysis).ResultsAt Week 52, patient-level SGIC responder and group-level SGIC analyses favored cipa+mig compared with alg+pbo across all SGIC domains (e.g. 90 vs. 59% responders in the cipa+mig vs. the alg+pbo group for SGIC ability to move around; P = 0.0005; and LS mean difference 0.385; P = 0.02). Similarly, PROMIS Physical Function and Fatigue domains numerically favored cipa+mig in both analyses (e.g. 50 vs. 40% responders in the cipa+mig vs. alg+pbo arm for PROMIS Physical Function; P = 0.37; and LS mean difference 3.1; P = 0.11). R-PAct for both treatment groups was similar in the patient-level responder analysis, but numerically favored alg+pbo in the group-level analysis (35% responders in both arms; P = 0.95; and LS mean difference −0.8; P = 0.48). Self-care, usual activities, and depression/anxiety domains of EQ-5D-5L numerically favored cipa+mig in both analyses (e.g. 20 vs. 12% responders in the cipa+mig vs. alg+pbo arm for EQ-5D-5L self-care; P = 0.54; and LS mean difference −0.108; P = 0.52).ConclusionsOverall, switching treatment from alglucosidase alfa to cipa+mig positively impacted PRO measurements during the double-blind period of PROPEL.Trial registrationNCT03729362; Registration date: November 1, 2018; https://clinicaltrials.gov/study/NCT03729362

Levels of female sex hormones in patients with premenstrual bronchial asthma

According to the clinical recommendations of the Ministry of Health of the Russian Federation in 2021, at least 348 million patients worldwide suffer from bronchial asthma (BA). The treatment of patients with BA has objective difficulties due to the progression of obstruction and insufficient diagnosis of pathogenetic forms of BA. It is known that in women, hormonal status, namely female sex hormones such as estradiol and progesterone, contributes to the course and development of BA. This article presents an original clinical study of 48 patients suffering from mild to moderate asthma with a regular menstrual cycle, and the relationship between the increase in symptoms of asthma and the phase of the menstrual cycle is estimated. According to the results of the study, all patients were divided into groups with regular asthma (RA) and premenstrual asthma (PMA). A significant increase in the level of estradiol was obtained (934.50 (405.00; 1010.25) pmol/l) in patients with PMA in the second phase of the menstrual cycle in relation to the control group (494.00 (328.00; 487.00) pmol/l) and the group of patients with RA (694.50 (495.25; 993.00) pmol/l). No significant and significant changes in progesterone, prolactin, LH, or FSH were detected. The revealed decrease in respiratory function in patients with PMA in the second phase of the menstrual cycle emphasizes and probably explains the worsening of symptoms of asthma in this group of patients, which, with possible hormonal correction, can lead to stabilization of the course of asthma.

Synchronous bilateral typical pulmonary carcinoid tumours diagnosed by robotic navigation bronchoscopy: A unique case.

Pulmonary carcinoids are uncommon malignant neoplasms, believed to derive from specialized neuroendocrine cells known as Kulchitsky cells. We evaluated a 69-year-old female presenting symptoms consistent with carcinoid syndrome, such as intermittent flushing and diarrhoea, along with complaints of shortness of breath and cough. Imaging revealed bilateral lung nodules, confirmed by biopsy to be carcinoid tumours. The treatment of choice for carcinoid tumours is complete surgical resection. Nonetheless, individualized management plans are crafted based on the tumour's location and the patient's respiratory function as these present challenges to anatomical resection of tumours.

Voice Assessment in Patients with Amyotrophic Lateral Sclerosis: An Exploratory Study on Associations with Bulbar and Respiratory Function.

Speech production is a possible way to monitor bulbar and respiratory functions in patients with amyotrophic lateral sclerosis (ALS). Moreover, the emergence of smartphone-based data collection offers a promising approach to reduce frequent hospital visits and enhance patient outcomes. Here, we studied the relationship between bulbar and respiratory functions with voice characteristics of ALS patients, alongside a speech therapist's evaluation, at the convenience of using a simple smartphone. For voice assessment, we considered a speech therapist's standardized tool-consensus auditory-perceptual evaluation of voice (CAPE-V); and an acoustic analysis toolbox. The bulbar sub-score of the revised ALS functional rating scale (ALSFRS-R) was used, and pulmonary function measurements included forced vital capacity (FVC%), maximum expiratory pressure (MEP%), and maximum inspiratory pressure (MIP%). Correlation coefficients and both linear and logistic regression models were applied. A total of 27 ALS patients (12 males; 61 years mean age; 28 months median disease duration) were included. Patients with significant bulbar dysfunction revealed greater CAPE-V scores in overall severity, roughness, strain, pitch, and loudness. They also presented slower speaking rates, longer pauses, and higher jitter values in acoustic analysis (all p < 0.05). The CAPE-V's overall severity and sub-scores for pitch and loudness demonstrated significant correlations with MIP% and MEP% (all p < 0.05). In contrast, acoustic metrics (speaking rate, absolute energy, shimmer, and harmonic-to-noise ratio) significantly correlated with FVC% (all p < 0.05). The results provide supporting evidence for the use of smartphone-based recordings in ALS patients for CAPE-V and acoustic analysis as reliable correlates of bulbar and respiratory function.

The Impact of Nusinersen Treatment on Respiratory Function in Patients with Spinal Muscular Atrophy: A Systematic Review.

Background/Objectives: This systematic review evaluated the impact of nusinersen therapy on respiratory health and function in individuals with spinal muscular atrophy (SMA) and determined whether nusinersen improves pulmonary function, focusing on differences based on patient age and the timing of treatment initiation. Methods: A systematic search of PubMed, Ovid Medline, ScienceDirect, and Web of Science databases was conducted up to January 2024 in accordance with the PRISMA guidelines. Thirteen studies were included, comprising clinical trials, observational studies, and case series that focused on respiratory outcomes in SMA patients treated with nusinersen. The data on study design, participant characteristics, nusinersen intervention, respiratory outcomes, and adverse events were extracted. The Joanna Briggs Institute Critical Appraisal Tool was used to assess study quality. A narrative synthesis was conducted to address the heterogeneity of the studies. Results: This review found a general trend of improvement in pulmonary function, specifically in forced vital capacity (FVC), although the extent and duration of improvement varied across the studies. Peak cough flow (PCF) and peak expiratory flow (PEF) showed positive trends in some studies, although the results were not consistently significant. Respiratory function improvements were frequently observed, particularly in younger patients and those treated earlier. Conclusions: Nusinersen appears to enhance respiratory function and improve motor outcomes in SMA patients, especially with early treatment. However, further research is needed to fully understand its mechanisms and long-term effects on respiratory health in SMA.

Robust Control of Exo-Abs, a Wearable Platform for Ubiquitous Respiratory Assistance

Abstract Existing noninvasive breathing assist options compatible with out-of-hospital settings are limited and not appropriate to enable essential everyday activities, thereby deteriorating the quality of life. In our prior work, we developed the Exo-Abs, a novel wearable robotic platform for ubiquitous assistance of respiratory functions in patients with respiratory deficiency. This paper concerns the development of a model-based closed-loop control algorithm for the Exo-Abs to automate its breathing assistance. To facilitate model-based development of closed-loop control algorithms, we developed a control-oriented mathematical model of the Exo-Abs. Then, we developed a robust absolutely stabilizing gain-scheduled proportional-integral control algorithm for automating the breathing assistance with the Exo-Abs, by (i) solving a linear matrix inequality formulation of the Lyapunov stability condition against sector-bounded uncertainty and interindividual variability in the mechanics of the abdomen and the lungs and (ii) augmenting it with a heuristic yet effective gain scheduling algorithm. Using in silico evaluation based on realistic and plausible virtual patients, we demonstrated the efficacy and robustness of the automated breathing assistance of the Exo-Abs under a wide range of variability in spontaneous breathing and Exo-Abs efficiency: the absolutely stabilizing gain-scheduled proportional-integral control resulted in small exhalation trajectory tracking error (&amp;lt;30 ml) with smooth actuation, which was superior to (i) its proportional-integral control counterpart in tracking efficacy and to (ii) its proportional-integral-derivative control counterpart in chattering.

Successful Bevacizumab Therapy in a 25-Year-Old Patient with Recurrent Respiratory Papillomatosis.

Recurrent respiratory papillomatosis (RRP) is a chronic condition caused primarily by human papilloma virus (HPV) types 6 and 11, leading to recurrent growths in the respiratory tract. These types of papilloma can cause significant morbidity due to airway obstruction, often requiring frequent surgical interventions. Traditional treatments, including surgical removal and adjunctive therapies like antivirals and immune modulators, often fail to prevent recurrence, impacting the patient's quality of life. This report presents a 25-year-old female with a long-standing history of RRP, diagnosed at age 2. Despite numerous interventions, including CO2 laser ablations, interferon therapy, HPV vaccination, and a laryngotomy with tracheal reconstruction, the patient continued to experience severe airway obstruction requiring frequent surgeries. In 2023, intravenous therapy with bevacizumab, vascular endothelial growth factor inhibitor was introduced, leading to a significant reduction in the frequency of surgical interventions from 8 to 4 per year. This reduction improved the patient's respiratory function and quality of life, highlighting bevacizumab's therapeutic potential. The case underscores the debilitating nature of RRP and the challenges of its management. Bevacizumab, by targeting vascular endothelial growth factor (VEGF), has shown promise in reducing papilloma growth and the need for frequent surgeries. This case supports the inclusion of bevacizumab as an adjunctive therapy in RRP treatment, warranting further research to confirm its long-term efficacy and safety. Recurrent respiratory papillomatosis is a rare and complex disease that severely impacts patients' quality of life.This case report demonstrates that bevacizumab can significantly reduce surgical interventions in recurrent respiratory papillomatosis (RRP), offering a promising treatment that improves management of this chronic condition.Bevacizumab, already used in treating various diseases by targeting VEGF, shows promise in managing RRP as well, highlighting its potential across multiple conditions and expanding its therapeutic versatility.

The interaction between craniocervical biomechanics, neck disability and respiratory functions in patients with chronic obstructive pulmonary disease

The interaction between craniocervical biomechanics, neck disability and respiratory functions in patients with chronic obstructive pulmonary disease

Naloxone combined with non-invasive ventilation for the treatment of chronic obstructive pulmonary disease based on radioactive X-ray image inspection

The purpose of this study was to investigate the application of radiography in patients with COPD and analyze its value in diagnosis and evaluation. During radiological X-rays, patients wear specific lead protective equipment to reduce radiation exposure and obtain images from different angles and fields of view. The obtained X-ray images were evaluated and analyzed to examine the structural and morphological features of the lung tissue. In this study, the treatment scheme of naloxone combined with salbutamol combined with non-invasive ventilator was adopted, which improved the effectiveness and accuracy of treatment by supporting the computer medical image segmentation recognition system. The analysis results showed that the respiratory function of patients in naloxone combined with non-invasive ventilation treatment group was significantly improved after treatment, and the lung image characteristics also had positive changes. Compared with the conventional treatment group, naloxone combined with noninvasive ventilation has significant advantages in improving ventilation function and reducing pulmonary disease in COPD patients. Naloxone combined with non-invasive ventilation based on medical image recognition has the potential to improve the condition of COPD patients and predict treatment response. The results of this study provide a new idea for the treatment of COPD patients and provide a reference for further optimization of treatment.

Correlation Analysis of Myasthenia Gravis Thymic Disease with Quantitative Score of Myasthenia Gravis Swallowing Function and Respiratory Function

Introduction: The pathophysiology of myasthenia gravis (MG), an autoimmune disease affecting the neuro-muscular junction, is closely related to thymic disorders (thymic hyperplasia, thymic involution, thymic neoplasms). Myasthenia gravis often causes or exacerbates thymus disease, which often occurs together with myasthenia gravis. Further studies are needed to determine the relationship between thymus properties and quantitative myasthenia gravis (QMG), swallowing, and respiratory function in patients with myasthenia gravis. Methods: From 2021 to 2022, 93 MG patients with definite thymic disease were found by thymic CT or histopathological biopsy in the Myasthenia Gravis Treatment Center of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine. The Quantitative Myasthenia Gravis (QMG) score was used by physicians at the deputy high level and above to measure patients' swallowing and respiratory function. The purpose of this study was to observe the relationship between myasthenia gravis thymic disease and QMG score, swallowing function score, and respiratory function score. Results：The poor swallowing function score (3 points) accounted for 58.9%, 4.8%, and 13.6% in the thymoma group, thymic hyperplasia group, and thymus without abnormality group, respectively, and the difference between the groups was statistically significant (P&lt;0.05). The respiratory function score was poor (3 points), and the thymus group accounted for 58.7%, which was significantly higher than the thymic hyperplasia group and the thymus without abnormality group. There was significant difference between groups (P&lt;0.05). Myasthenia gravis quantitative score (QMG)&gt;20 points (severe), the thymoma group accounted for 77%, which was significantly larger than the thymic hyperplasia group, and the thymus group had no abnormality, and the difference between the groups was significant (P&lt;0.05). After multiple comparison test results, it was found that the QMG score of the thymoma group was 1.07298 higher than that of the normal thymus, and the difference was significant. The swallowing score of the thymoma group was 1.461 higher than that of the normal thymus group, and the difference was significant. The respiratory function score of the thymoma group was 0.832 higher than that of the normal thymus group, and the difference was significant. The lung function score of the thymoma group was significantly higher than that of the thymic hyperplasia group by 1.509.

Motor and Respiratory Tele-Rehabilitation in Patients with Long COVID-19 after Hospital Discharge: An Interventional Study.

The persistence of symptoms following COVID-19 infection represents a significant challenge in healthcare management. During the outbreak, tele-rehabilitation emerged as a new tool to support healthcare structures in providing rehabilitation services. This study assessed the effectiveness and the feasibility of a 3-week home-based motor and respiratory rehabilitation program for individuals with long COVID-19 after traditional rehabilitation. Twenty-three patients completed the program and underwent functional tests at different time points (i.e., baseline, at discharge from in-hospital rehabilitation and after tele-rehabilitation). Motor function was evaluated using the instrumented Six-Minutes Walking Test (i6MWT), with monitored heart rate and oxygen saturation. Additionally, respiratory function was measured via forced vital capacity (FVC) and maximal voluntary ventilation (MVV) tests. Significant improvements (p < 0.05) in motor and respiratory function were observed throughout the intervention, including an 18.3% increase in walked distance from the baseline. The findings suggest that the proposed home-based tele-rehabilitation shows potential in enhancing motor and respiratory function in patients with long COVID. Despite limitations such as the small sample size, lack of control group and the preliminary nature of the outcomes observed, the overall findings seem to support the feasibility of the proposed tele-rehabilitation program in managing long COVID symptoms and promoting functional recovery. Nevertheless, further research is needed to validate these findings and explore tele-rehabilitation's potential in broader and different patient populations.

Influence of Transverse Abdominis Plane Block on Intraoperative Diaphragmatic and Respiratory Functions in Patients Receiving Laparoscopic Colorectal Surgery.

The positive roles of deep muscle relaxation in abdominal surgeries and transversus abdominis plane block (TAPB) in the postoperative analgesia. This study aimed to discuss the effects of TAPB on abdominal muscle relaxation, the intraoperative diaphragmatic, and the respiratory functions. The patients were randomly divided into the TAPB group who received single-shot TAPB bilaterally (n=30), and the control group who did not receive TAPB (n=30). Both groups keep the same steps for other procedures in the surgeries and anesthesia. Four time points for monitoring were defined: The moment when pneumoperitoneum pressure stabilized following endotracheal intubation and anesthetic induction (T0), appearance of the first incisure in the pressure-volume (P-V) loop (T1), appearance of the second incisure in the P-V loop (T2), and the moment with single stimulation (SS) =20% (T3). Primary observation parameters were SS1 measured by muscle relaxation monitoring at T1, and SS2 at T2. Secondary observation parameters included surgeon's satisfaction with surgical field and respiratory dynamics at the four time points. The two groups were comparable in age, gender, BMI, ASA grade, and operation time. The TAPB group had a dramatic reduction in the total dose of intraoperative sufentanil (0.73±0.21 ug/kg) compared with the control group (0.87±0.18 ug/kg) (P=0.023); Other use of drug did not differ between the two groups. The two groups did not differ significantly in SS at either T1 (SS1) or T2 (SS2). In either group, surgeon's satisfaction with surgical field at T1 and T2 decreased dramatically compared with T0 and T3 (all P<0.05). At each time point, the respiratory dynamics and the surgeon's satisfaction with surgical field did not differ significantly between the two groups. TAPB reduced the use of intraoperative analgesics without altering the degree of abdominal relaxation, or affecting surgeon's satisfaction with surgical field in the patients receiving laparoscopic colorectal surgery.

1873: CT-based radiomics and respiratory function in patients receiving lung RT: an exploratory analysis

1873: CT-based radiomics and respiratory function in patients receiving lung RT: an exploratory analysis

Advanced Respiratory Monitoring during Extracorporeal Membrane Oxygenation.

Advanced respiratory monitoring encompasses a diverse range of mini- or noninvasive tools used to evaluate various aspects of respiratory function in patients experiencing acute respiratory failure, including those requiring extracorporeal membrane oxygenation (ECMO) support. Among these techniques, key modalities include esophageal pressure measurement (including derived pressures), lung and respiratory muscle ultrasounds, electrical impedance tomography, the monitoring of diaphragm electrical activity, and assessment of flow index. These tools play a critical role in assessing essential parameters such as lung recruitment and overdistention, lung aeration and morphology, ventilation/perfusion distribution, inspiratory effort, respiratory drive, respiratory muscle contraction, and patient-ventilator synchrony. In contrast to conventional methods, advanced respiratory monitoring offers a deeper understanding of pathological changes in lung aeration caused by underlying diseases. Moreover, it allows for meticulous tracking of responses to therapeutic interventions, aiding in the development of personalized respiratory support strategies aimed at preserving lung function and respiratory muscle integrity. The integration of advanced respiratory monitoring represents a significant advancement in the clinical management of acute respiratory failure. It serves as a cornerstone in scenarios where treatment strategies rely on tailored approaches, empowering clinicians to make informed decisions about intervention selection and adjustment. By enabling real-time assessment and modification of respiratory support, advanced monitoring not only optimizes care for patients with acute respiratory distress syndrome but also contributes to improved outcomes and enhanced patient safety.

Detection of dynamic lung hyperinflation using cardiopulmonary exercise testing and respiratory function in patients with stable cardiac disease: a multicenter, cross-sectional study.

Many patients with heart disease potentially have comorbid chronic obstructive pulmonary disease (COPD); however, there are not enough opportunities for screening, and the qualitative differentiation of shortness of breath (SOB) has not been well established. We investigated the detection rate of SOB based on a visual and qualitative dynamic lung hyperinflation (DLH) detection index during cardiopulmonary exercise testing (CPET) and assessed potential differences in respiratory function between groups. We recruited 534 patients with heart disease or patients who underwent simultaneous CPET and spirometry (369 males, 67.0 ± 12.9 years) to scrutinize physical functions. The difference between inspiratory and expiratory tidal volume was calculated (TV E-I) from the breath-by-breath data. Patients were grouped into convex (decreased TV E-I) and non-convex (unchanged or increased TV E-I) groups based on their TV E-I values after the start of exercise. Among the recruited patients, 129 (24.2%) were categorized in the convex group. There was no difference in clinical characteristics between the two groups. The Borg scale scores at the end of the CPET showed no difference. VE/VCO2 slope, its Y-intercept, and minimum VE/VCO2 showed no significant difference between the groups. In the convex group, FEV1.0/FVC was significantly lower compared to that in the non-convex group (69.4 ± 13.1 vs. 75.0 ± 9.0%). Moreover, significant correlations were observed between FEV1.0/FVC and Y-intercept (r=-0.343), as well as between the difference between minimum VE/VCO2 and VE/VCO2 slope (r=-0.478). The convex group showed decreased respiratory function, suggesting a potential airway obstruction during exercise. A combined assessment of the TV E-I and Y-intercept of the VE/VCO2 slope or the difference between the minimum VE/VCO2 and VE/VCO2 slopes could potentially detect COPD or airway obstruction.

뇌졸중 환자의 삼킴 장애와 호흡기능, 호흡근 근력과의 상관관계

Purpose: Dysphagia is a common secondary complication in patients with stroke, and restrictive ventilation is observed. This study aimed to analyze the correlation between dysphagia, respiratory function, and respiratory muscle strength. Methods: In 20 patients with stroke, dysphagia was evaluated through videofluoroscopic swallowing tests. Based on a PAS score of 5, patients were classified into a stroke group with and without dysphagia according to whether they were eligible for dysphagia treatment. Forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1),ratioofFEV1 to FVC (FEV1/FVC), peak expiratory velocity (PEF), and maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) were assessed. Results: Among the respiratory function evaluation factors, PEF showed significant differences depending on the presence or absence of dysphagia between the two groups. Respiratory muscle strength in MIP and MEP was significantly lower in the stroke group with dysphagia. After analyzing the correlation between the dysphagia group and respiratory function in patients with stroke, PEF (r=−.660, p&lt;.05), MIP (r=−.576, p&lt;.05), and MEP (r=−.524, p&lt;.05) showed statistically significant correlations. Conclusions: The lower the respiratory muscle strength in patients with stroke, the more likely they will experience dysphagia. This can be used as clinical data on respiratory exercises and swallowing rehabilitation for patients with stroke.