Source: Annual Congress 2009 - Cystic fibrosis: advances in clinical research

Abstract

Introduction:
Neural respiratory drive (NRD) quantified by electromyography (EMG) of the diaphragm is a marker of disease severity in COPD (Jolley et al. Eur Respir J 2009; 33(2): 289-297). The measurement of diaphragm EMG (EMGdi) is invasive, which may limit its clinical application. The parasternal intercostal muscles are obligate respiratory muscles and recording the EMG (EMGpara) from them using surface electrodes could provide a non invasive method to assess NRD.
Hypothesis:
We hypothesised that NRD assessed using EMGpara would be related to disease severity in cystic fibrosis (CF).
Methods:
Twelve patients [mean (SD) age 23(5) years] with moderate to severe CF [mean (SD) FEV₁ % predicted 53(18.8) %] and ten age matched [23(2) years] healthy subjects were recruited. EMGdi was measured using a multipair oesphageal catheter and EMGpara from surface electrodes. For EMG analysis the root mean square (RMS) was calculated and peak RMS of the resting EMG was expressed as a percentage of peak RMS of the maximum (EMG %max) obtained during inspiratory capacity manoeuvres.
Results:
EMGdi%max was correlated to EMGpara%max (r = 0.504, p=0.024). Mean (SD) EMGdi%max 16.10 (5.94) and EMGpara%max 14.27 (6.99) were significantly higher in the CF patients compared to healthy subjects [EMGdi %max 7.38 (3.4), p = 0.002, EMGpara %max 5.89 (2.65), p = 0.003]. EMGdi%max was correlated to FEV₁ % predicted (r = -0.708, p = 0.015) and EMGpara%max was correlated to FEV₁ % predicted (r = -0.667, p = 0.018), VC % predicted (r = -0.699, p = 0.011) and RV % predicted (r = 0.677, p = 0.031).
Conclusion:
EMGpara is a non invasive method to assess NRD and provides an index of disease severity in CF.

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Citations should be made in the following way:
C. Reilly, K. Ward, C. Jolley, A. Lunt, J. Steier, C. Elston, G. F. Rafferty, J. Moxham (London, United Kingdom). Neural respiratory drive and disease severity in cystic fibrosis. Eur Respir J 2009; 34: Suppl. 53, 1254

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