Disability and rehabilitation · 2024
The accuracy of respiratory muscle strength in identifying systolic dysfunction in patients with Chagas cardiomyopathy.
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Silva Keity Lamary Souza, de Carvalho Bastone Alessandra, Ávila Matheus Ribeiro, de Alcantara Marcus Alessandro, Trede Filho Renato Guilherme, de Oliveira Luciano Fonseca Lemos, Silva Whesley Tanor, de Oliveira Lucas Fróis Fernandes, Mendonça Vanessa Amaral, Lacerda Ana Cristina Rodrigues, Lima Vanessa Pereira, de Castro Faria Sanny Cristina, Mediano Mauro Felippe Felix, Figueiredo Pedro Henrique Scheidt, Costa Henrique Silveira
Аннотация
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.
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.