Diaphragmatic dysfunction in patients with chronic heart failure

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OBJECTIVE

To detect diaphragmatic dysfunction in patients with chronic heart failure (CHF) via assessment of structural and functional state of external respiration.

MATERIAL AND METHODS

The study was conducted at the Almazov National Medical Research Center and included 58 subjects. There were 40 patients with CHF and 18 ones without CHF (control group). Inclusion criterion for the main group was CHF NYHA class II—IV. Exclusion criteria for both groups were pulmonary diseases, morbid obesity, abdominal diseases and anemia. We performed ultrasonic assessment of structural (thickness) and functional (thickening fraction and excursion) state of diaphragm under calm and deep inhalation/exhalation. External respiration was assessed using spirometry functions of a ventilator.

RESULTS

Patients with CHF had a thicker diaphragm on both sides and smaller volume of deep inhalation. Diaphragm thickening index was significantly less under deep inhalation on the right. Patients with CHF had a larger excursion of the right and left domes of the diaphragm under calm breathing, whereas no significant differences were found under deep breathing. We found a moderate positive linear correlation between CHF and diaphragm thickness on both sides under calm inhalation.

CONCLUSION

Structural and functional diaphragmatic dysfunction makes a contribution to respiratory failure in patients with CHF.

Keywords:

diaphragmatic dysfunction

chronic heart failure

sonography of diaphragm

diaphragm

lung function

diaphragmatic function

Authors:

V.S. Shabaev

Almazov National Medical Research Centre

ORCID: 0000-0002-5336-003X

I.V. Orazmagomedova

Almazov National Medical Research Centre

ORCID: 0000-0001-9629-4450

V.A. Mazurok

Almazov North-Western Federal Medical Research Center

ORCID: 0000-0003-3917-0771

A.V. Berezina

Almazov National Medical Research Center

ORCID: 0000-0002-5770-3845

A.E. Bautin

Almazov National Medical Research Center

ORCID: 0000-0001-5031-7637

L.G. Vasilyeva

Almazov National Medical Research Center

ORCID: 0000-0001-9611-9222

D.A. Aleksandrova

Almazov National Medical Research Center

ORCID: 0000-0002-0734-7344

Received:

03.05.2023

Accepted:

06.06.2023

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