It has been suggested that impaired respiratory muscle function occurs in patients with PH (pulmonary hypertension); however, comprehensive investigations of respiratory muscle function, including the application of non-volitional tests, needed to verify impairment of respiratory muscle strength in patients with PH have not yet been performed. In the present study, respiratory muscle function was assessed in 31 patients with PH (20 females and 11 males; mean pulmonary artery pressure, 51±20 mmHg; median World Health Organization class 3.0±0.5; 25 patients with pulmonary arterial hypertension and six patients with chronic thromboembolic PH) and in 31 control subjects (20 females and 11 males) well-matched for gender, age and BMI (body mass index). A 6-min walking test was performed to determine exercise capacity. Volitionally assessed maximal inspiratory (7.5±2.1 compared with 6.2±2.8 kPa; P=0.04) and expiratory (13.3±4.2 compared with 9.9±3.4 kPa; P<0.001) mouth pressures, sniff nasal (8.3±1.9 compared with 6.6±2.2 kPa; P=0.002) and transdiaphragmatic (11.3±2.5 compared with 8.7±2.5 kPa; P<0.001) pressures, non-volitionally assessed twitch mouth (1.46±0.43 compared with 0.97±0.41 kPa; P<0.001) and transdiaphragmatic (2.08±0.55 compared with 1.47±0.72 kPa; P=0.001) pressures during bilateral anterior magnetic phrenic nerve stimulation were markedly lower in patients with PH compared with control subjects. Maximal inspiratory mouth (r=0.58, P<0.001) and sniff transdiaphragmatic (r=0.43, P=0.02) pressures were correlated with the 6-min walking distance in patients with PH. In conclusion, the present study provides strong evidence that respiratory muscle strength is reduced in patients with PH compared with well-matched control subjects. Furthermore, the 6-min walking distance is significantly linked to parameters assessing inspiratory muscle strength.
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January 2008
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Research Article|
December 11 2007
Impairment of respiratory muscle function in pulmonary hypertension
Hans-Joachim Kabitz;
Hans-Joachim Kabitz
*Department of Pneumology, University Hospital Freiburg, D-79106 Freiburg Germany
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Anja Schwoerer;
Anja Schwoerer
*Department of Pneumology, University Hospital Freiburg, D-79106 Freiburg Germany
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Hinrich-Cordt Bremer;
Hinrich-Cordt Bremer
*Department of Pneumology, University Hospital Freiburg, D-79106 Freiburg Germany
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Florian Sonntag;
Florian Sonntag
*Department of Pneumology, University Hospital Freiburg, D-79106 Freiburg Germany
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Stephan Walterspacher;
Stephan Walterspacher
*Department of Pneumology, University Hospital Freiburg, D-79106 Freiburg Germany
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David Walker;
David Walker
*Department of Pneumology, University Hospital Freiburg, D-79106 Freiburg Germany
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Vanessa Schaefer;
Vanessa Schaefer
†Department of Cardiology and Pneumology, University Hospital Heidelberg, D-69120 Heidelberg, Germany
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Nicola Ehlken;
Nicola Ehlken
†Department of Cardiology and Pneumology, University Hospital Heidelberg, D-69120 Heidelberg, Germany
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Gerd Staehler;
Gerd Staehler
‡Department of Pneumology and Cardiology, Loewenstein Hospital, D-74245 Loewenstein, Germany
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Michael Halank;
Michael Halank
§Department of Internal Medicine I, University Hospital Dresden, D-01307 Dresden, Germany
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Hans Klose;
Hans Klose
∥Department of Pneumology, University Hospital Hamburg-Eppendorf, D-20246 Hamburg, Germany
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Hossein A. Ghofrani;
Hossein A. Ghofrani
¶Department of Pneumology, University Hospital Giessen, D-35392 Giessen, Germany
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Marius M. Hoeper;
Marius M. Hoeper
**Department of Pneumology, Hannover Medical School, D-30625 Hannover, Germany
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Ekkehard Gruenig;
Ekkehard Gruenig
†Department of Cardiology and Pneumology, University Hospital Heidelberg, D-69120 Heidelberg, Germany
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Wolfram Windisch
*Department of Pneumology, University Hospital Freiburg, D-79106 Freiburg Germany
Correspondence: Dr Wolfram Windisch (email [email protected]).
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Publisher: Portland Press Ltd
Received:
July 09 2007
Revision Received:
August 16 2007
Accepted:
September 03 2007
Accepted Manuscript online:
September 03 2007
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© The Authors Journal compilation © 2008 Biochemical Society
2008
Clin Sci (Lond) (2008) 114 (2): 165–171.
Article history
Received:
July 09 2007
Revision Received:
August 16 2007
Accepted:
September 03 2007
Accepted Manuscript online:
September 03 2007
Citation
Hans-Joachim Kabitz, Anja Schwoerer, Hinrich-Cordt Bremer, Florian Sonntag, Stephan Walterspacher, David Walker, Vanessa Schaefer, Nicola Ehlken, Gerd Staehler, Michael Halank, Hans Klose, Hossein A. Ghofrani, Marius M. Hoeper, Ekkehard Gruenig, Wolfram Windisch; Impairment of respiratory muscle function in pulmonary hypertension. Clin Sci (Lond) 1 January 2008; 114 (2): 165–171. doi: https://doi.org/10.1042/CS20070238
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