Source: Annual Congress 2010 - Respiratory and peripheral muscles: From basic mechanisms to altered function
Disease area: Airway diseases

Abstract

INTRODUCTION: Respiratory muscles show dysfunction in patients suffering from COPD. Diaphragm and accessory muscle dysfunction associates with variables such as dyspnea, hypercapnia, and susceptibility to severe exacerbations. AIM: To evaluate the potential association between respiratory muscle function and survival in COPD patients.METHODS: 200 COPD patients was followed during 10 years. Pulmonary function tests and respiratory muscle strength (PImax, PEmax) were performed at the beginning of follow-up. Clinical variables, hospitalisations, comorbidity, and cause of death were registered. The association between muscle function and survival was estimated using Cox proportional-hazard regression model. RESULTS: PImax values ranged 20-157% pred. All-cause mortality was 21%. 7% of patients died from causes related to lung cancer. Inspiratory muscle weakness (PImax <80% pred) was associated with an increased risk of death (HR=2.6,p=0.005;CI95%=1.3-5.1). This increased risk remained significant in patients who died from causes other than advanced cancer (HR=3.6;p=0.015;IC95%=1.3-10.1). A stepwise increase was observed in the mortality risk according to predefined PImax intervals, even when adjusting for pulmonary function. CONCLUSIONS: This study shows that an association exists between inspiratory muscle weakness and mortality in patients with COPD. This finding supports respiratory muscle strength must be included as an additional estimator of mortality risk. Specific intervention on inspiratory muscles might have a clinical impact on survival in COPD patients (FISISCIII PI081612, FISISCIII PI061698, Beca SOCAP 2006 and CIBER de Enfermedades Respiratorias ISCIII).

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A. Ramirez Sarmiento, S. Pascual Guardia, J. Martinez Llorens, J. Gea, M. Orozco Levi (Barcelona, Spain). Inspiratory muscle strength predicts mortality in patients with chronic obstructive pulmonary disease. Eur Respir J 2010; 36: Suppl. 54, 3412

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