Longitudinal follow-up of quadriceps strength and function in a COPD cohort after 3 years

Buttery, Sara C; Mohan, Divya; Fisk, Marie; Hopkinson, Nicholas S; Tal‐Singer, Ruth; Wilkinson, Ian B.; Polkey, Michael I.

doi:10.1183/13993003.00707-2017

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…While the evaluation of the quadriceps muscle using Qcsa or Qthick in patients with COPD has already been reported, 18,[27][28][29][30][31][32][33][34][35] this is the first study to evaluate the use of ultrasonography to assess the quadriceps contractile index (Qci) in this population. Our main results could be summarized as follows: 1) the measurement of Qthick, Qcsa and Qci is feasible, simple, rapid and reliable in this population, 2) although all three indices showed some degree of relationship to other clinically significant markers of disease severity, Qci performed best with regards to its correlation to airflow obstruction, hyperinflation, dyspnea and CAT score/quality of life and 3) Qci was independently related not only to FFMI but also to diaphragm contractile activity.…”

Section: Discussionmentioning

confidence: 99%

<p>Ultrasound Evaluation of the Quadriceps Muscle Contractile Index in Patients with Stable Chronic Obstructive Pulmonary Disease: Relationships with Clinical Symptoms, Disease Severity and Diaphragm Contractility</p>

Maynard-Paquette

Poirier

Chartrand-Lefèbvre

et al. 2020

COPD

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Rationale: Chronic obstructive pulmonary disease (COPD) is associated with changes in the composition and function of peripheral and respiratory muscles, which can negatively impact quality of life. Ultrasonography can provide a non-invasive evaluation of the integrity of both peripheral muscles and diaphragm, but its use in patients with COPD is still being investigated. We aimed at evaluating the relationship between quadriceps size, using ultrasonography and symptoms, lung function and diaphragm contractility in a cohort of patients with COPD. Methods: COPD patients were prospectively recruited and ultrasonography of the dominant quadriceps and of the diaphragm was performed. Quadriceps size was evaluated using three measurements: 1) cross-sectional area of the rectus femoris (Qcsa), 2) thickness (Qthick) and 3) contractile index (Qci), defined as the ratio of quadriceps thickness/total anterior thigh thickness. Diaphragm contractility was evaluated using thickening fraction (TFdi). Clinical characteristics and number of moderate-to-severe exacerbations in the previous year were retrieved from medical files. Dyspnea (mMRC scale) and disease impact on health status (COPD Assessment Test (CAT)) were measured at inclusion. Fat-free mass index (FFMI) was assessed using bioelectrical impedance. Results: Forty patients were recruited (20 males, mean age and FEV 1 66±6 years and 49 ±17%predicted, respectively). Mean Qcsa, Qthick and Qci were 336±145 mm 2 , 1.55 ±0.53 cm and 64±16%, respectively, and mean TFdi was 91±36%. Qci was significantly correlated with FFMI (rho=0.59, p=0.001), TFdi (rho=0.41, p=0.008), FEV 1 (rho=0.43, p=0.001) but not with age (rho=0.18, p=0.28). Qci was significantly correlated to CAT score (rho=−0.47, p=0.002), even when controlled for FEV 1 , and was lower in patients with an mMRC score ≥2 (55±15 vs 70±14%, p=0.002). Qcsa and Qci were significantly lower in patients with frequent exacerbations. In a multiple linear regression analysis that included age, gender, FFMI, FEV 1 and TFdi, only FFMI and TFdi were found to be significantly related to lower Qci values. Conclusion:In patients with COPD, ultrasound evaluation of the quadriceps contractile index is feasible and related to disease severity, clinical symptoms, exacerbation history and diaphragm contractility. As such, it may provide a novel tool for the evaluation of the severity and burden of the disease in this population. Further studies are required to better delineate its potential role as a prognostic marker in this population.

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