MRI-assessed diaphragmatic function can predict frequent acute exacerbation of COPD: a prospective observational study based on telehealth-based monitoring system
Abstract Background Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have considerably high mortality and re-hospitalisation rate. Diaphragmatic dysfunction (DD) is common in COPD patients. However, whether diaphragmatic dysfunction is related to acute exacerbation is yet to be...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-022-02254-x |
| _version_ | 1811187005744218112 |
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| author | Shuoshuo Wei Rong Lu Zhengping Zhang Faxuan Wang Hai Tan Xiaohong Wang Jinlan Ma Yating Zhang Ning Deng Juan Chen |
| author_facet | Shuoshuo Wei Rong Lu Zhengping Zhang Faxuan Wang Hai Tan Xiaohong Wang Jinlan Ma Yating Zhang Ning Deng Juan Chen |
| author_sort | Shuoshuo Wei |
| collection | DOAJ |
| description | Abstract Background Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have considerably high mortality and re-hospitalisation rate. Diaphragmatic dysfunction (DD) is common in COPD patients. However, whether diaphragmatic dysfunction is related to acute exacerbation is yet to be elucidated. This study aimed to evaluate the diaphragm function by magnetic resonance imaging (MRI) in COPD patients and assess whether the impact of DD may help predict AECOPD. Methods 20 healthy adult volunteers and 80 COPD patients were enrolled. The diaphragms function parameters were accessed by MRI. Patients were guided to start self-management by the Telehealth-based monitoring system following the enrolment. Events of acute exacerbation of COPD were recorded by the system and confirmed by healthcare providers. Binary univariate and multivariate logistic regression analyses were performed to investigate the factors associated with the frequency of AECOPD. Receiver operating characteristic (ROC) curves were further used to assess the value of prediction indexes. Results Fifty-nine COPD patients completed a one-year follow-up based on the Telehealth-based monitoring system. The clinical outcomes showed that the diaphragm function parameters at the end of maximal breathing were lower in the COPD group than in the healthy control group (P < 0.05). ANOVA showed significant differences among Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages for diaphragm function parameters, including chest wall motion, lung area, upper-lower diameter, and the diaphragm thickening fraction at the end of maximal breathing (P < 0.05). Moreover, significant differences in diaphragm function parameters were observed between patients with infrequent AECOPD (n = 28) and frequent AECOPD (n = 31) based on the frequency of AECOPD (P < 0.05). The diaphragm thickening fraction and the chest wall motion were associated with AECOPD after adjusting for age, sex, BMI, and lung functions, and the combination of predictions showed better accuracy in predicting the frequency of AECOPD. Conclusions In COPD patients, diaphragm function parameters correlate with the severity of airflow limitation. The diaphragm thickening fraction and the chest wall motion were associated with the frequency of AECOPD and can predict it. |
| first_indexed | 2024-04-11T13:54:56Z |
| format | Article |
| id | doaj.art-5e807471b0234f82a633176e2c49c049 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-04-11T13:54:56Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-5e807471b0234f82a633176e2c49c0492022-12-22T04:20:22ZengBMCBMC Pulmonary Medicine1471-24662022-11-0122111610.1186/s12890-022-02254-xMRI-assessed diaphragmatic function can predict frequent acute exacerbation of COPD: a prospective observational study based on telehealth-based monitoring systemShuoshuo Wei0Rong Lu1Zhengping Zhang2Faxuan Wang3Hai Tan4Xiaohong Wang5Jinlan Ma6Yating Zhang7Ning Deng8Juan Chen9Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical UniversityDepartment of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical UniversityDepartment of Radiology, General Hospital of Ningxia Medical UniversityNingxia Medical UniversityDepartment of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical UniversityDepartment of Critical Care Medicine, General Hospital of Ningxia Medical UniversityDepartment of Critical Care Medicine, General Hospital of Ningxia Medical UniversityDepartment of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical UniversityMinistry of Education Key Laboratory of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Zhejiang UniversityDepartment of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical UniversityAbstract Background Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have considerably high mortality and re-hospitalisation rate. Diaphragmatic dysfunction (DD) is common in COPD patients. However, whether diaphragmatic dysfunction is related to acute exacerbation is yet to be elucidated. This study aimed to evaluate the diaphragm function by magnetic resonance imaging (MRI) in COPD patients and assess whether the impact of DD may help predict AECOPD. Methods 20 healthy adult volunteers and 80 COPD patients were enrolled. The diaphragms function parameters were accessed by MRI. Patients were guided to start self-management by the Telehealth-based monitoring system following the enrolment. Events of acute exacerbation of COPD were recorded by the system and confirmed by healthcare providers. Binary univariate and multivariate logistic regression analyses were performed to investigate the factors associated with the frequency of AECOPD. Receiver operating characteristic (ROC) curves were further used to assess the value of prediction indexes. Results Fifty-nine COPD patients completed a one-year follow-up based on the Telehealth-based monitoring system. The clinical outcomes showed that the diaphragm function parameters at the end of maximal breathing were lower in the COPD group than in the healthy control group (P < 0.05). ANOVA showed significant differences among Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages for diaphragm function parameters, including chest wall motion, lung area, upper-lower diameter, and the diaphragm thickening fraction at the end of maximal breathing (P < 0.05). Moreover, significant differences in diaphragm function parameters were observed between patients with infrequent AECOPD (n = 28) and frequent AECOPD (n = 31) based on the frequency of AECOPD (P < 0.05). The diaphragm thickening fraction and the chest wall motion were associated with AECOPD after adjusting for age, sex, BMI, and lung functions, and the combination of predictions showed better accuracy in predicting the frequency of AECOPD. Conclusions In COPD patients, diaphragm function parameters correlate with the severity of airflow limitation. The diaphragm thickening fraction and the chest wall motion were associated with the frequency of AECOPD and can predict it.https://doi.org/10.1186/s12890-022-02254-xAcute exacerbationChronic obstructive pulmonary diseaseClosed-loop care pathwayDiaphragm functionMagnetic resonance imaging |
| spellingShingle | Shuoshuo Wei Rong Lu Zhengping Zhang Faxuan Wang Hai Tan Xiaohong Wang Jinlan Ma Yating Zhang Ning Deng Juan Chen MRI-assessed diaphragmatic function can predict frequent acute exacerbation of COPD: a prospective observational study based on telehealth-based monitoring system BMC Pulmonary Medicine Acute exacerbation Chronic obstructive pulmonary disease Closed-loop care pathway Diaphragm function Magnetic resonance imaging |
| title | MRI-assessed diaphragmatic function can predict frequent acute exacerbation of COPD: a prospective observational study based on telehealth-based monitoring system |
| title_full | MRI-assessed diaphragmatic function can predict frequent acute exacerbation of COPD: a prospective observational study based on telehealth-based monitoring system |
| title_fullStr | MRI-assessed diaphragmatic function can predict frequent acute exacerbation of COPD: a prospective observational study based on telehealth-based monitoring system |
| title_full_unstemmed | MRI-assessed diaphragmatic function can predict frequent acute exacerbation of COPD: a prospective observational study based on telehealth-based monitoring system |
| title_short | MRI-assessed diaphragmatic function can predict frequent acute exacerbation of COPD: a prospective observational study based on telehealth-based monitoring system |
| title_sort | mri assessed diaphragmatic function can predict frequent acute exacerbation of copd a prospective observational study based on telehealth based monitoring system |
| topic | Acute exacerbation Chronic obstructive pulmonary disease Closed-loop care pathway Diaphragm function Magnetic resonance imaging |
| url | https://doi.org/10.1186/s12890-022-02254-x |
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