Ultrasound Shear Wave Elastography for Evaluation of Diaphragm Stiffness in Patients with Stable <scp>COPD</scp>: A Pilot Trial

Xu, Jinghong; Wu, Zhenzhou; Tao, Fang-Yi; Zhu, Shu-Ting; Chen, Shun-Ping; Cai, Chang; Liang, Zenghui; Shi, Binbin; Chen, Bin; Xie, Yupeng

doi:10.1002/jum.15655

Cited by 14 publications

(26 citation statements)

References 36 publications

(40 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…87 Unlike the quadriceps, muscle stiffness as measured by shear wave velocity has been found to be increased in the diaphragm, indicating a higher muscle stiffness. 88 The stretch-shortening cycle of the vastus lateralis showed higher potentiation in PwCOPD compared to those without. 89 This was also inversely associated with muscle thickness, pennation angle, and habitual gait speed.…”

Section: Muscle Mechanicsmentioning

confidence: 86%

Updated Perspectives on the Role of Biomechanics in COPD: Considerations for the Clinician

Yentes¹,

Liu²,

Markvicka³

et al. 2022

COPD

View full text Add to dashboard Cite

Patients with chronic obstructive pulmonary disease (COPD) demonstrate extra-pulmonary functional decline such as an increased prevalence of falls. Biomechanics offers insight into functional decline by examining mechanics of abnormal movement patterns. This review discusses biomechanics of functional outcomes, muscle mechanics, and breathing mechanics in patients with COPD as well as future directions and clinical perspectives. Patients with COPD demonstrate changes in their postural sway during quiet standing compared to controls, and these deficits are exacerbated when sensory information (eg, eyes closed) is manipulated. If standing balance is disrupted with a perturbation, patients with COPD are slower to return to baseline and their muscle activity is differential from controls. When walking, patients with COPD appear to adopt a gait pattern that may increase stability (eg, shorter and wider steps, decreased gait speed) in addition to altered gait variability. Biomechanical muscle mechanics (ie, tension, extensibility, elasticity, and irritability) alterations with COPD are not well documented, with relatively few articles investigating these properties. On the other hand, dyssynchronous motion of the abdomen and rib cage while breathing is well documented in patients with COPD. Newer biomechanical technologies have allowed for estimation of regional, compartmental, lung volumes during activity such as exercise, as well as respiratory muscle activation during breathing. Future directions of biomechanical analyses in COPD are trending toward wearable sensors, big data, and cloud computing. Each of these offers unique opportunities as well as challenges. Advanced analytics of sensor data can offer insight into the health of a system by quantifying complexity or fluctuations in patterns of movement, as healthy systems demonstrate flexibility and are thus adaptable to changing conditions. Biomechanics may offer clinical utility in prediction of 30-day readmissions, identifying disease severity, and patient monitoring. Biomechanics is complementary to other assessments, capturing what patients do, as well as their capability.

show abstract

Section: Muscle Mechanicsmentioning

confidence: 86%

Updated Perspectives on the Role of Biomechanics in COPD: Considerations for the Clinician

Yentes¹,

Liu²,

Markvicka³

et al. 2022

COPD

View full text Add to dashboard Cite

show abstract

“…This was an observational study using ultrasound SWE to measure diaphragm stiffness, so we referred to previous studies, and a sample size of 50 patients per group was sufficient. [16] SPSS 24.0 statistical software (IBM Corporation, Armonk, NY) was used to analyze and process all data. The Kolmogorov-Smirnov method was used to test the normality of the measurement data.…”

Section: Discussionmentioning

confidence: 99%

Shear wave elastography of the diaphragm in acute exacerbation of chronic obstructive pulmonary disease: A prospective observational study

Zhang¹,

Zhang

Yan³

et al. 2023

Medicine

View full text Add to dashboard Cite

Patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are prone to diaphragmatic dysfunction. However, dynamic assessment of diaphragmatic function is complex and difficult, and whether the assessment of diaphragmatic function can reflect clinical indicators such as lung function in AECOPD patients remains unclear. We studied diaphragm stiffness and diaphragm stiffening rate (DSR) in AECOPD patients with acute exacerbations ≥ 2 times within 1 year and their correlation with clinical data, the diaphragmatic thickening fraction (DTF), lung function, and blood gas values. In total, 112 AECOPD patients in group C and Group D who had acute exacerbations ≥ 2 times within 1 year in the Global Initiative for Chronic Obstructive Lung Disease Guideline A (low risk, few symptoms), B (low risk, many symptoms), C (High risk, few symptoms), D (High risk, many symptoms) grouping system were included in the study. Their general clinical data, chronic obstructive pulmonary disease assessment test (CAT), modified medical research council (mMRC), number of acute exacerbations in 1 year, DTF, lung function, and blood gas analysis were collected. The diaphragm shear wave elasticity at functional residual capacity (DsweFRC) and DSR were measured by ultrasound. The DsweFRC and DSR of Group D were higher than those of Group C (P < .05). DsweFRC, DSR were negatively correlated with DTF, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and FEV1/FVC (r ranged from −0.293 to −0.697, all P < .05), and positively correlated with CAT score, mMRC score, and arterial carbon dioxide pressure (r ranged from 0.274 to 0.462, all P < .05) in both groups; the correlation coefficients of DsweFRC, DSR and DTF, FEV1/FVC in group D were greater than those in group C. There was no correlation between DsweFRC, DSR and arterial oxygen partial pressure in both groups (P > .05). The DsweFRC, DSR increased with the number of acute exacerbations per year in both groups. We found that diaphragmatic stiffness in AECOPD patients increased with the number of acute exacerbations within 1 year, correlated with DTF, CAT, mMRC, lung function, and arterial carbon dioxide pressure and provides a simple and practical method for dynamically assessing diaphragmatic function and disease severity in AECOPD patients.

show abstract

“…Additionally, diaphragm SWE negatively correlated with pulmonary ventilation function and body mass indexes but positively correlated with health status. [ 32 ] Thus, diaphragm measurements may help diagnose, treat, and follow-up assessments of patients with COPD. Also, ultrasound examinations combined with the degree of diaphragm stiffness provide a more comprehensive evaluation of diaphragm function.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic evaluation of diaphragm function in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis

et al. 2022

View full text Add to dashboard Cite

Background: Some studies have reported using ultrasonic evaluations to assess diaphragm function in patients with chronic obstructive pulmonary disease (COPD). However, they have limitations and thus cannot provide strong evidence to support ultrasound evaluations for diaphragm function and dysfunction severity assessments in this patient population. Additionally, quantitative studies on the relationship between ultrasound evaluations and diaphragm function do not exist. Therefore, we performed a systematic review and meta-analysis to explore the usefulness of ultrasonography for evaluating diaphragm function in patients with COPD. Methods: The Cochrane Library, PubMed, Embase, Web of Science, Chinese Biomedical Literature Database, Wanfang Data, China National Knowledge Network, and Chinese Scientific Journal Database (i.e., VIP) databases were searched for literature about ultrasonic evaluations of diaphragm function in patients with COPD for systematic review. We extracted patient demographic, diaphragm mobility, diaphragm thickness, diaphragm thickening score, and other related parameter data using RevMan 5.3 software for the meta-analysis. Results: We included 13 articles in the systematic review, 8 of which (494 participants) were included in the meta-analysis. The degree of diaphragm offset in patients with COPD was significantly lower than that in healthy controls (weighted mean difference [WMD] = –1.34; 95% confidence interval [CI]: –2.15, 0.53; P < .05). The diaphragm deviation was lower in the severe COPD group than in the mild-to-moderate COPD group (WMD = 0.50; 95% CI: –0.01, 1.01; P = .06), but the difference was not significant. Conclusion: Ultrasonography effectively evaluates diaphragm function in patients with COPD. The diaphragm offset can be used as an auxiliary diagnostic index for COPD, which is also related to disease severity.

show abstract

Ultrasound Shear Wave Elastography for Evaluation of Diaphragm Stiffness in Patients with Stable COPD: A Pilot Trial

Cited by 14 publications

References 36 publications

Updated Perspectives on the Role of Biomechanics in COPD: Considerations for the Clinician

Updated Perspectives on the Role of Biomechanics in COPD: Considerations for the Clinician

Shear wave elastography of the diaphragm in acute exacerbation of chronic obstructive pulmonary disease: A prospective observational study

Ultrasonographic evaluation of diaphragm function in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis

Contact Info

Product

Resources

About