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Determinants of diaphragm inspiratory motion, diaphragm thickening, and its performance for predicting respiratory restrictive pattern in Duchenne muscular dystrophy

Abdallah Fayssoil 1, 2, 3, 4, 5, 6 Lee Nguyen 7, 8, 9, 10 Tanya Stojkovic 2 Helene Prigent 5, 11, 6 Robert Carlier 6, 12 Helge Amthor 5, 13, 6 Jean Bergounioux 13, 6 Justine Zini 13, 6 Sebastien Damez‐fontaine 13, 6 Karim Wahbi 2, 14, 15 Pascal Laforet 5, 13, 6 Guillaume Nicolas 13, 6, 16 Anthony Behin 2 Guillaume Bassez 2 France Leturcq 17 Rabah Ben Yaou 17 Nicolas Mansencal 3, 4 Djillali Annane 1, 6 Frédéric Lofaso 5, 11, 6 David Orlikowski 1, 18, 6
9 CRPV Paris Pitié - Centre régional de Pharmacovigilance [CHU Pitié]
Service de Pharmacologie médicale [CHU Pitié-Salpêtrière]
16 MIMETIC - Analysis-Synthesis Approach for Virtual Human Simulation
UR2 - Université de Rennes 2, Inria Rennes – Bretagne Atlantique , IRISA-D5 - RÉALITÉ VIRTUELLE, HUMAINS VIRTUELS, INTERACTIONS ET ROBOTIQUE
Abstract : Introduction/aims: Respiratory status is a key determinant of prognosis in patients with Duchenne muscular dystrophy (DMD). We aimed to evaluate the determinants of diaphragm ultrasound and its performance in predicting restrictive respiratory patterns in DMD. Methods: This was a retrospective study of DMD patients followed in our center and admitted for an annual checkup from 2015 to 2018. We included DMD patients who underwent diaphragm ultrasound and pulmonary functional tests. Results: This study included 74 patients with DMD. The right diaphragm thickening fraction (TF) was significantly associated with age (P = .001), Walton score (P = .012), inspiratory capacity (IC) (P = .004), upright forced vital capacity (FVC) (P < .0001), supine FVC (P = .038), and maximal inspiratory pressure (MIP) (P = .002). Right diaphragm excursion was significantly associated with age (P < .0001), steroid use (P = .008), history of spinal fusion (P < .0001), body mass index (BMI) (P = .002), Walton score (P < .0001), IC (P < .0001), upright FVC (P < .0001), supine FVC (P < .0001), and MIP (P < .0001). A right diaphragm TF >28% and a right diaphragm excursion>25.4 mm were associated with an FVC >50% with, respectively, an area under the curve (AUC) of 0.95 (P = .001) and 0.93 (P < .001). A left diaphragm TF >26.8% and a left diaphragm excursion >21.5 mm were associated with an FVC >50% with, respectively, an AUC of 0.95 (P = .011) and 0.97 (P < .001). Discussion: Diaphragm excursion and diaphragm TF can predict restrictive pulmonary insufficiency in DMD.
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Submitted on : Tuesday, January 11, 2022 - 2:01:38 PM
Last modification on : Friday, May 20, 2022 - 11:06:57 AM
Long-term archiving on: : Tuesday, April 12, 2022 - 7:08:54 PM

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Abdallah Fayssoil, Lee Nguyen, Tanya Stojkovic, Helene Prigent, Robert Carlier, et al.. Determinants of diaphragm inspiratory motion, diaphragm thickening, and its performance for predicting respiratory restrictive pattern in Duchenne muscular dystrophy. Muscle & nerve. Supplement., 2022, 65 (1), pp.89-95. ⟨10.1002/mus.27432⟩. ⟨hal-03521139⟩

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