The accuracy of respiratory muscle strength in identifying systolic dysfunction in patients with Chagas cardiomyopathy.

IF 2.1 4区医学 Q1 REHABILITATION

Disability and Rehabilitation Pub Date : 2025-06-01 Epub Date: 2024-11-08 DOI:10.1080/09638288.2024.2425749

Keity Lamary Souza Silva, Alessandra de Carvalho Bastone, Matheus Ribeiro Ávila, Marcus Alessandro de Alcantara, Renato Guilherme Trede Filho, Luciano Fonseca Lemos de Oliveira, Whesley Tanor Silva, Lucas Fróis Fernandes de Oliveira, Vanessa Amaral Mendonça, Ana Cristina Rodrigues Lacerda, Vanessa Pereira Lima, Sanny Cristina de Castro Faria, Mauro Felippe Felix Mediano, Pedro Henrique Scheidt Figueiredo, Henrique Silveira Costa

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Abstract

Purpose: To verify the accuracy of respiratory muscle strength in identifying systolic dysfunction in patients with Chagas cardiomyopathy (ChC), and to validate optimal cutoff points based on respiratory muscle strength.

Methods: First, 72 patients with ChC were enrolled and underwent echocardiography and assessment of respiratory muscle strength by manovacuometry. Inspiratory and expiratory muscle strength was defined by maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), respectively. Systolic dysfunction was defined by left ventricular ejection fraction (LVEF) values below 52% (for men) or 54% (for women). Then, the validation of the cutoff points was verified by the percentage of true and false positives in another 30 ChC patients.

Results: The MIP showed adequate accuracy (p = 0.004) in identifying patients with systolic dysfunction (AUC = 0.73). The MEP did not show satisfactory accuracy in identifying those patients. The optimal MIP cutoff point to identify systolic dysfunction in ChC was ≤62 cmH₂O, with a positive predictive value of 87%. In the validation analysis, MIP values below 62 cmH₂O were able to identify 77% of patients with systolic dysfunction.

Conclusion: MIP has potential value in identifying systolic dysfunction in patients with ChC. This finding may aid in screening and risk stratification when echocardiography is not available.

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呼吸肌强度在识别南美锥虫病心肌病患者收缩功能障碍方面的准确性。

目的：验证呼吸肌肌力在识别恰加斯心肌病（ChC）患者收缩功能障碍方面的准确性，并验证基于呼吸肌肌力的最佳临界点：首先，72 名恰加斯心肌病患者接受了超声心动图检查和呼吸肌力测定。吸气和呼气肌力分别以最大吸气压（MIP）和最大呼气压（MEP）定义。收缩功能障碍的定义是左心室射血分数（LVEF）低于 52%（男性）或 54%（女性）。然后，在另外 30 名慢性阻塞性肺病患者中通过真假阳性率验证了截断点的有效性：MIP在识别收缩功能障碍患者（AUC = 0.73）方面显示出足够的准确性（p = 0.004）。而 MEP 在识别这些患者方面的准确性并不令人满意。识别 ChC 收缩功能障碍的最佳 MIP 切点是≤62 cmH2O，阳性预测值为 87%。在验证分析中，低于 62 cmH2O 的 MIP 值能够识别 77% 的收缩功能障碍患者：结论：MIP 在识别胆囊收缩功能障碍患者方面具有潜在价值。结论：MIP 在识别胆囊炎患者收缩功能障碍方面具有潜在价值，这一发现可能有助于在无法进行超声心动图检查时进行筛查和风险分层。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Disability and Rehabilitation 医学-康复医学

CiteScore

5.00

自引率

9.10%

发文量

415

审稿时长

3-6 weeks

期刊介绍： Disability and Rehabilitation along with Disability and Rehabilitation: Assistive Technology are international multidisciplinary journals which seek to encourage a better understanding of all aspects of disability and to promote rehabilitation science, practice and policy aspects of the rehabilitation process.