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. 2024 Apr;19(3):705-711.
doi: 10.1007/s11739-024-03531-9. Epub 2024 Feb 16.

Diaphragmatic ultrasound evaluation in acute heart failure: clinical and functional associations

Affiliations

Diaphragmatic ultrasound evaluation in acute heart failure: clinical and functional associations

Simone Scarlata et al. Intern Emerg Med. 2024 Apr.

Abstract

Heart failure patients often experience respiratory symptoms due to diaphragmatic involvement, but the diaphragmatic motion in heart failure remains understudied. This research aimed to investigate the correlation between ultrasonographically assessed diaphragmatic motion and thickness with cardiac performance indexes in an emergency setting. Seventy-two acutely decompensated heart failure patients and 100 non-heart failure individuals were enrolled. Diaphragmatic motion and thickness were assessed via ultrasound. Cardiac and respiratory parameters were recorded, and regression analysis was performed. Heart failure patients exhibited reduced diaphragmatic motion at total lung capacity compared to controls, and an inverse association was found between motion and heart failure severity (NYHA stage). Diaphragmatic thickness was also higher in heart failure patients at tidal volume and total lung capacity. Notably, diaphragmatic motion inversely correlated with systolic pulmonary artery pressure. The study highlights diaphragmatic dysfunction in acutely decompensated heart failure, with reduced motion and increased thickness. These changes were associated with cardio-respiratory parameters, specifically systolic pulmonary artery pressure. Monitoring diaphragmatic motion via ultrasound may aid in evaluating heart failure severity and prognosis in emergency settings. Additionally, interventions targeting diaphragmatic function could improve heart failure management. Further research is warranted to enhance heart failure management and patient outcomes.

Keywords: Diaphragm ultrasound; Emergency; Heart failure; NYHA.

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References

    1. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A; ESC Scientific Document Group (2021) ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021(42):3599–3726
    1. Olson TP, Beck KC, Johnson JB, Johnson BD (2006) Competition for intrathoracic space reduces lung capacity in patients with chronic heart failure: a radiographic study. Chest 130:164–171 - DOI - PubMed
    1. Verissimo P, Timenetsky KT, Casalaspo TJA, Gonçalves LHR, Yang ASY, Eid RC (2015) High prevalence of respiratory muscle weakness in hospitalized acute heart failure elderly patients. PLoS ONE 10(2):e0118218 - DOI - PubMed - PMC
    1. Lena A, Anker MS, Springer J (2020) Muscle wasting and sarcopenia in heart failure—the current state of science. Int J Mol Sci 21:6549 - DOI - PubMed - PMC
    1. Miyagi M, Kinugasa Y, Sota T, Yamada K, Ishisugi T, Hirai M, Yanagihara K, Haruki N, Matsubara K, Kato M, Yamamoto K (2018) Diaphragm muscle dysfunction in patients with heart failure. J Card Fail 24:209–216 - DOI - PubMed

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