Spiesshoefer, Jens, Lutter, Riccarda, Kabitz, Hans-Joachim, Henke, Carolin, Herkenrath, Simon, Randerath, Winfried, Young, Peter, Dreher, Michael, Goerlich, Dennis and Boentert, Matthias (2021). Respiratory Muscle Function Tests and Diaphragm Ultrasound Predict Nocturnal Hypoventilation in Slowly Progressive Myopathies. Front. Neurol., 12. LAUSANNE: FRONTIERS MEDIA SA. ISSN 1664-2295

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Abstract

Introduction: In slowly progressive myopathies, diaphragm weakness early manifests through sleep-related hypoventilation as reflected by nocturnal hypercapnia. This study investigated whether daytime tests of respiratory muscle function and diaphragm ultrasound predict hypercapnia during sleep.</p> Methods: Twenty-seven patients with genetic myopathies (myotonic dystrophy type 1 and 2, late-onset Pompe disease, facioscapulohumeral dystrophy; 48 +/- 11 years) underwent overnight transcutaneous capnometry, spirometry, measurement of mouth occlusion pressures, and diaphragm ultrasound.</p> Results: Sixteen out of 27 patients showed nocturnal hypercapnia (peak p(tc)CO(2) >= 50 mmHg for >= 30 min or increase in p(tc)CO(2) by 10 mmHg or more from the baseline value). In these patients, forced vital capacity (FVC; % predicted) and maximum inspiratory pressure (MIP; % of lower limit or normal or LLN) were significantly reduced compared to normocapnic individuals. Nocturnal hypercapnia was predicted by reduction in FVC of <60% [sensitivity, 1.0; area under the curve (AUC), 0.82] and MIP (%LLN) <120% (sensitivity, 0.83; AUC, 0.84), the latter reflecting that in patients with neuromuscular disease, pretest likelihood of abnormality is per se higher than in healthy subjects. Diaphragm excursion velocity during a sniff maneuver excluded nocturnal hypercapnia with high sensitivity (0.90) using a cutoff of 8.0 cm/s.</p> Conclusion: In slowly progressive myopathies, nocturnal hypercapnia is predicted by FVC <60% or MIP <120% (LLN). As a novelty, nocturnal hypercapnia can be excluded with acceptable sensitivity by diaphragm excursion velocity >8.0 cm/s on diaphragm ultrasound.</p>

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Spiesshoefer, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lutter, RiccardaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kabitz, Hans-JoachimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Henke, CarolinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herkenrath, SimonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Randerath, WinfriedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Young, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dreher, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goerlich, DennisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boentert, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-595974
DOI: 10.3389/fneur.2021.731865
Journal or Publication Title: Front. Neurol.
Volume: 12
Date: 2021
Publisher: FRONTIERS MEDIA SA
Place of Publication: LAUSANNE
ISSN: 1664-2295
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
BREATHING DISORDERS; DAYTIME PREDICTORS; REFERENCE VALUES; SLEEP; DYSTROPHY; PREVALENCEMultiple languages
Clinical Neurology; NeurosciencesMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/59597

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