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Inspiratory muscle activation increases with COPD severity as confirmed by non-invasive mechanomyographic analysis

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dc.contributor.author Sarlabous, Leonardo
dc.contributor.author Torres, Abel
dc.contributor.author Fiz, José Antonio
dc.contributor.author Martínez-Llorens, Juana Mª
dc.contributor.author Gea Guiral, Joaquim
dc.contributor.author Jané, Raimon
dc.date.accessioned 2018-01-22T11:36:45Z
dc.date.available 2018-01-22T11:36:45Z
dc.date.issued 2017
dc.identifier.citation Sarlabous L, Torres A, Fiz JA, Martínez-Llorens JM, Gea J, Jané R. Inspiratory muscle activation increases with COPD severity as confirmed by non-invasive mechanomyographic analysis. PLoS One. 2017 May 18;12(5):e0177730. DOI: 10.1371/journal.pone.0177730
dc.identifier.issn 1932-6203
dc.identifier.uri http://hdl.handle.net/10230/33715
dc.description.abstract There is a lack of instruments for assessing respiratory muscle activation during the breathing cycle in clinical conditions. The aim of the present study was to evaluate the usefulness of the respiratory muscle mechanomyogram (MMG) for non-invasively assessing the mechanical activation of the inspiratory muscles of the lower chest wall in both patients with chronic obstructive pulmonary disease (COPD) and healthy subjects, and to investigate the relationship between inspiratory muscle activation and pulmonary function parameters. Both inspiratory mouth pressure and respiratory muscle MMG were simultaneously recorded under two different respiratory conditions, quiet breathing and incremental ventilatory effort, in 13 COPD patients and 7 healthy subjects. The mechanical activation of the inspiratory muscles was characterised by the non-linear multistate Lempel-Ziv index (MLZ) calculated over the inspiratory time of the MMG signal. Subsequently, the efficiency of the inspiratory muscle mechanical activation was expressed as the ratio between the peak inspiratory mouth pressure to the amplitude of the mechanical activation. This activation estimated using the MLZ index correlated strongly with peak inspiratory mouth pressure throughout the respiratory protocol in both COPD patients (r = 0.80, p<0.001) and healthy (r = 0.82, p<0.001). Moreover, the greater the COPD severity in patients, the greater the level of muscle activation (r = -0.68, p = 0.001, between muscle activation at incremental ventilator effort and FEV1). Furthermore, the efficiency of the mechanical activation of inspiratory muscle was lower in COPD patients than healthy subjects (7.61±2.06 vs 20.42±10.81, respectively, p = 0.0002), and decreased with increasing COPD severity (r = 0.78, p<0.001, between efficiency of the mechanical activation at incremental ventilatory effort and FEV1). These results suggest that the respiratory muscle mechanomyogram is a good reflection of inspiratory effort and can be used to estimate the efficiency of the mechanical activation of the inspiratory muscles. Both, inspiratory muscle activation and inspiratory muscle mechanical activation efficiency are strongly correlated with the pulmonary function. Therefore, the use of the respiratory muscle mechanomyogram can improve the assessment of inspiratory muscle activation in clinical conditions, contributing to a better understanding of breathing in COPD patients.
dc.description.sponsorship This work was supported in part by the Secretariat of Universities and Research of the Ministry of Economy and Knowledge of the Generalitat de Catalunya (consolidated research groups GRC 2014 SGR 1569 and 424, and CERCA Programme), the Plan Nacional (SAF2014-54371), and by the Ministry of Economy and Competitiveness of the Spanish Government and the European Regional Development Fund, DPI2015-68820-R (MINECO/FEDER).
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Public Library of Science (PLoS)
dc.relation.ispartof PLoS One. 2017 May 18;12(5):e0177730
dc.rights © 2017 Sarlabous et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
dc.rights.uri https://creativecommons.org/licenses/by/4.0/
dc.title Inspiratory muscle activation increases with COPD severity as confirmed by non-invasive mechanomyographic analysis
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1371/journal.pone.0177730
dc.subject.keyword Chronic obstructive pulmonary disease
dc.subject.keyword Pulmonary function
dc.subject.keyword Thoracic diaphragm
dc.relation.projectID info:eu-repo/grantAgreement/ES/1PE/SAF2014-54371
dc.relation.projectID info:eu-repo/grantAgreement/ES/1PE/DPI2015-68820-R
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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