Universität zu Köln

Spiesshoefer, Jens ORCID: 0000-0001-8205-1749, Henke, Carolin, Kabitz, Hans Joachim, Nofer, Jerzy Roch, Mohr, Michael, Evers, Georg, Strecker, Jan-Kolia, Brix, Tobias, Randerath, Winfried Johannes, Herkenrath, Simon, Schmidt, Lars Henning and Boentert, Matthias (2020). Respiratory Muscle and Lung Function in Lung Allograft Recipients: Association with Exercise Intolerance. Respiration, 99 (5). S. 398 - 409. BASEL: KARGER. ISSN 1423-0356

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Abstract

Background: In lung transplant recipients (LTRs), restrictive ventilation disorder may be present due to respiratory muscle dysfunction that may reduce exercise capacity. This might be mediated by pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6). Objective: We investigated lung respiratory muscle function as well as circulating pro-inflammatory cytokines and exercise capacity in LTRs. Methods: Fifteen LTRs (6 female, age 56 +/- 14 years, 63 +/- 45 months post-transplantation) and 15 healthy controls matched for age, sex, and body mass index underwent spirometry, measurement of mouth occlusion pressures, diaphragm ultrasound, and recording of twitch transdiaphragmatic (twPdi) and gastric pressures (twPgas) following magnetic stimulation of the phrenic nerves and the lower thoracic nerve roots. Exercise capacity was quantified using the 6-min walking distance (6MWD). Plasma IL-6 and TNF-alpha were measured using enzyme-linked immunosorbent assays. Results: Compared with controls, patients had lower values for forced vital capacity (FVC; 81 +/- 30 vs.109 +/- 18% predicted, p = 0.01), maximum expiratory pressure (100 +/- 21 vs.127 +/- 17 cm H2O, p = 0.04), diaphragm thickening ratio (2.2 +/- 0.4 vs. 3.0 +/- 1.1, p = 0.01), and twPdi (10.4 +/- 3.5 vs. 17.6 +/- 6.7 cm H2O, p = 0.01). In LTRs, elevation of TNF-alpha was related to lung function (13 +/- 3 vs. 11 +/- 2 pg/mL in patients with FVC <= 80 vs. >80% predicted; p < 0.05), and lung function (forced expiratory volume after 1 s) was closely associated with diaphragm thickening ratio (r = 0.81; p < 0.01) and 6MWD (r = 0.63; p = 0.02). Conclusion: There is marked restrictive ventilation disorder and respiratory muscle weakness in LTRs, especially inspiratory muscle weakness with diaphragm dysfunction. Lung function impairment relates to elevated levels of circulating TNF-alpha and diaphragm dysfunction and is associated with exercise intolerance.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Spiesshoefer, Jens UNSPECIFIED orcid.org/0000-0001-8205-1749 UNSPECIFIED Henke, Carolin UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabitz, Hans Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Nofer, Jerzy Roch UNSPECIFIED UNSPECIFIED UNSPECIFIED Mohr, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Evers, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Strecker, Jan-Kolia UNSPECIFIED UNSPECIFIED UNSPECIFIED Brix, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Randerath, Winfried Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Herkenrath, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Lars Henning UNSPECIFIED UNSPECIFIED UNSPECIFIED Boentert, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-334973
DOI:	10.1159/000507264
Journal or Publication Title:	Respiration
Volume:	99
Number:	5
Page Range:	S. 398 - 409
Date:	2020
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1423-0356
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OBSTRUCTIVE PULMONARY-DISEASE; CERVICAL MAGNETIC STIMULATION; HEART-LUNG; DIAPHRAGM; TRANSPLANTATION; SKELETAL; PERFORMANCE; DYSFUNCTION; MYOPATHY; CAPACITY Multiple languages Respiratory System Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33497