Optoelectronic Pletysmography and Diaphragmatic Thickness in Heart Failure Patients

Universidade Federal de Pernambuco

Status: Unknown

Conditions: Heart Failure

Treatments: Other: Maximal exercise ramp test

Study type: Observational

Funder types: Other

Identifiers

NCT02481388

jasiel02

Details and patient eligibility

About

The investigators aimed to evaluate the effects of cardiomegaly associated with inspiratory muscle weakness on tricompartmental distribution of chest wall volumes, on the thickness of the right hemidiaphragm and on the contraction speed of the respiratory muscles. As method of the present research, a pilot cross-sectional study was conducted with fourteen (14) patients with heart failure, functional class II and III, clinically stable, with cardiomegaly. Two groups were formed: one group with inspiratory muscle weakness (WG) (maximal inspiratory pressure - MIP <70% predicted MIP) and a control group without weakness (CG). The pulmonary and respiratory muscle functions were assessed by spirometry and manometer, respectively. Before and after maximal exercise test, optoelectronic plethysmography was performed to evaluate the distribution of volumes, the kinematics and the contraction speed of chest wall muscles. The high-resolution ultrasonography was also used before and after the maximum test for obtaining diaphragmatic thickness

Enrollment: 14 estimated patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Both sexes, 18-60 years;
• Functional Class II-III according to the New York Heart Association;
• Echocardiography of the last six months showing showing left ventricular ejection fraction (LVEF) ≤ 45% measured by Teichholz method;
• Echocardiography the last six months showing cardiac hypertrophy (Diameter of Left Ventricular Diastolic (LVDD)> 54 mm, diameter of Systolic Left Ventricular (LVSD)> 34mm) 30 measured by Teichholz method;
• Optimized by the medical point of view and
• Clinical stability

Exclusion criteria

• Unstable angina; myocardial infarction or heart surgery up to three months before the survey;
• Orthopedic diseases, infectious or chronic metabolic diseases;
• The relation between forced expiratory volume in the first second and forced vital capacity (FEV1 / FVC) <70% of predicted characterizing obstructive respiratory disorder and
• Active smokers.

Trial design

14 participants in 2 patient groups

Weakness Group (WG)

Description:

Patients with heart failure and a maximum inspiratory pressure (MIP) \<70% of predicted MIP to age, considered as inspiratory muscle weakness. Following the recruitment process, these volunteers will be evaluated by spirometry and manovacuometry. Afterwards, volunteers will be also assessed in a maximal exercise ramp test. Before and after the ramp test, the optoelectronic pletysmography will be performed to analyse the chest wall tricompartmental distribution and the shortening velocities of rib cages muscles. Also a high-definition ultrasonography will be performed to measure the right diaphragmatic cupule thickness

Treatment:

Other: Maximal exercise ramp test

Control group (CG)

Description:

Patients with heart failure and do not have a maximum inspiratory pressure (MIP) \> 70% of predicted MIP to age, considered as inspiratory muscle weakness. Following the recruitment process, these volunteers will be evaluated by spirometry and manovacuometry. Afterwards, volunteers will be also assessed in a maximal exercise ramp test. Before and after the ramp test, the optoelectronic pletysmography will be performed to analyse the chest wall tricompartmental distribution and the shortening velocities of rib cages muscles. Also a high-definition ultrasonography will be performed to measure the right diaphragmatic cupule thickness

Treatment:

Other: Maximal exercise ramp test