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Abstract：
BACKGROUND: The diaphragm function assessed by ultrasound has been well-studied in COPD, asthma, and intensive care. However, there are only a few studies on diffuse interstitial lung disease, while dyspnea and quality of life are major issues in the management that may depend on the diaphragm.
METHODS: We retrospectively included idiopathic pulmonary fibrosis (IPF) patients followed in our center (Marseille, France) between January 2020 and February 2023 who underwent diaphragmatic ultrasound. Our objectives were to describe the diaphragmatic function of IPFs compared to healthy controls and to correlate with clinical, functional, and lung density on CT-scan.
RESULTS: 24 IPF patients and 157 controls were included. The diaphragmatic amplitude in IPF was increased at rest (median of 2.20 cm vs 1.88 cm on the right, p < 0.007, and 2.30 cm vs 1.91 cm on the left, p < 0.03, in IPF and controls respectively) and decreased in deep breathing (median of 4.85 cm vs 5.45 cm on the right, p < 0.009, and 5.10 cm vs 5.65 cm on the left, p < 0.046, in IPF and controls respectively). Diaphragmatic thickness was significantly reduced at rest on the right side (median of 1.75 mm vs 2.00 mm, p < 0.02, in IPF and controls respectively) and in deep breathing on both sides compared to controls (mean of 3.82 mm vs 4.15 mm on the right, p < 0.02, and 3.53 mm vs 3.94 mm, on the left, p < 0.009, in IPF and controls respectively). Diaphragmatic amplitude in deep breathing was moderate to strongly correlated with FVC, DLCO, and 6MWT and negatively correlated with the dyspnea and lung density on CT scan.
CONCLUSIONS: The diaphragmatic amplitude and thickness were impaired in IPF compared to controls. Diaphragmatic amplitude is the parameter best correlated with clinical, functional, and lung density criteria. Further studies are needed to determine if diaphragmatic amplitude can be a prognostic factor in IPF.
METHODS: We retrospectively included idiopathic pulmonary fibrosis (IPF) patients followed in our center (Marseille, France) between January 2020 and February 2023 who underwent diaphragmatic ultrasound. Our objectives were to describe the diaphragmatic function of IPFs compared to healthy controls and to correlate with clinical, functional, and lung density on CT-scan.
RESULTS: 24 IPF patients and 157 controls were included. The diaphragmatic amplitude in IPF was increased at rest (median of 2.20 cm vs 1.88 cm on the right, p < 0.007, and 2.30 cm vs 1.91 cm on the left, p < 0.03, in IPF and controls respectively) and decreased in deep breathing (median of 4.85 cm vs 5.45 cm on the right, p < 0.009, and 5.10 cm vs 5.65 cm on the left, p < 0.046, in IPF and controls respectively). Diaphragmatic thickness was significantly reduced at rest on the right side (median of 1.75 mm vs 2.00 mm, p < 0.02, in IPF and controls respectively) and in deep breathing on both sides compared to controls (mean of 3.82 mm vs 4.15 mm on the right, p < 0.02, and 3.53 mm vs 3.94 mm, on the left, p < 0.009, in IPF and controls respectively). Diaphragmatic amplitude in deep breathing was moderate to strongly correlated with FVC, DLCO, and 6MWT and negatively correlated with the dyspnea and lung density on CT scan.
CONCLUSIONS: The diaphragmatic amplitude and thickness were impaired in IPF compared to controls. Diaphragmatic amplitude is the parameter best correlated with clinical, functional, and lung density criteria. Further studies are needed to determine if diaphragmatic amplitude can be a prognostic factor in IPF.
摘要：
背景：在COPD中已经对超声评估的膈肌功能进行了充分的研究，哮喘,和重症监护。然而,关于弥漫性间质性肺病的研究很少,而呼吸困难和生活质量是管理中的主要问题，可能取决于隔膜。
方法：我们回顾性纳入了我们中心随访的特发性肺纤维化（IPF）患者（马赛，法国）在2020年1月至2023年2月期间接受了膈肌超声检查。我们的目标是描述与健康对照相比，IPFs的膈肌功能，并与临床相关，功能，CT扫描的肺密度.
结果：纳入24例IPF患者和157例对照。IPF的膈肌振幅在休息时增加（中位数为2.20cm，右侧为1.88cm，p<0.007，左侧为2.30厘米vs1.91厘米，p<0.03，分别在IPF和对照组中）和深呼吸降低（中位数为4.85厘米，右侧为5.45厘米，p<0.009，左侧为5.10厘米vs5.65厘米，p<0.046，分别在IPF和对照中）。在右侧休息时，膈肌厚度显着减少（中位数为1.75mmvs2.00mm，p<0.02，分别在IPF和对照组中）和与对照组相比，两侧的深呼吸（平均值为3.82mm，右侧为4.15mm，p<0.02，3.53mm对3.94mm，在左边,p<0.009，分别在IPF和对照中）。深呼吸中的膈肌振幅与FVC中等至强相关，DLCO,和6MWT，并与呼吸困难和CT扫描的肺密度呈负相关。
结论：与对照组相比，IPF的膈肌振幅和厚度受损。膈肌振幅是与临床最相关的参数，功能，和肺密度标准。需要进一步的研究来确定膈肌振幅是否是IPF的预后因素。
方法：我们回顾性纳入了我们中心随访的特发性肺纤维化（IPF）患者（马赛，法国）在2020年1月至2023年2月期间接受了膈肌超声检查。我们的目标是描述与健康对照相比，IPFs的膈肌功能，并与临床相关，功能，CT扫描的肺密度.
结果：纳入24例IPF患者和157例对照。IPF的膈肌振幅在休息时增加（中位数为2.20cm，右侧为1.88cm，p<0.007，左侧为2.30厘米vs1.91厘米，p<0.03，分别在IPF和对照组中）和深呼吸降低（中位数为4.85厘米，右侧为5.45厘米，p<0.009，左侧为5.10厘米vs5.65厘米，p<0.046，分别在IPF和对照中）。在右侧休息时，膈肌厚度显着减少（中位数为1.75mmvs2.00mm，p<0.02，分别在IPF和对照组中）和与对照组相比，两侧的深呼吸（平均值为3.82mm，右侧为4.15mm，p<0.02，3.53mm对3.94mm，在左边,p<0.009，分别在IPF和对照中）。深呼吸中的膈肌振幅与FVC中等至强相关，DLCO,和6MWT，并与呼吸困难和CT扫描的肺密度呈负相关。
结论：与对照组相比，IPF的膈肌振幅和厚度受损。膈肌振幅是与临床最相关的参数，功能，和肺密度标准。需要进一步的研究来确定膈肌振幅是否是IPF的预后因素。
