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Difference in diaphragmatic motion during tidal breathing in a standing position between COPD patients and normal
Yoshitake Yamada1, Masako Ueyama2, Takehiko Abe3
1Department of Radiology, Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02215, USA; Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Objectives:
To quantitatively compare diaphragmatic motion during tidal breathing in a standing position between chronic obstructive pulmonary disease (COPD) patients and normal subjects using dynamic chest radiography.
Materials And Methods:
Thirty-nine COPD patients (35 males; age, 71.3±8.4years) and 47 normal subjects (non-smoker healthy volunteers) (20 males; age, 54.8±9.8years) underwent sequential chest radiographs during tidal breathing using dynamic chest radiography with a flat panel detector system. We evaluated the excursions and peak motion speeds of the diaphragms. The results were analyzed using an unpaired t-test and a multiple linear regression model.
Results:
The excursions of the diaphragms in COPD patients were significantly larger than those in normal subjects (right, 14.7±5.5mm vs. 10.2±3.7mm, respectively, P<0.001; left, 17.2±4.9mm vs. 14.9±4.2mm, respectively, P=0.022). Peak motion speeds in inspiratory phase were significantly faster in COPD patients compared to normal subjects (right, 16.3±5.0mm/s vs. 11.8±4.2mm/s, respectively, P<0.001; left, 18.9±4.9mm/s vs. 16.7±4.0mm/s, respectively, P=0.022). The multivariate analysis demonstrated that having COPD and higher body mass index were independently associated with increased excursions of the bilateral diaphragm (all P<0.05), after adjusting for other clinical variables.
Conclusions:
Time-resolved quantitative evaluation of the diaphragm using dynamic chest radiography demonstrated that the diaphragmatic motion during tidal breathing in a standing position is larger and faster in COPD patients than in normal subjects.
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