Clinical importance of cross-sectional area of intercostal muscles in patients with chronic obstructive pulmonary disease

Clin Respir J. 2018 Mar;12(3):939-947. doi: 10.1111/crj.12609. Epub 2017 Jan 25.

Abstract

Introduction: Limb muscle wasting is one of main systemic manifestation of chronic obstructive pulmonary disease (COPD). However, the change of respiratory muscle is unclear.

Objectives: This study assessed the cross-sectional area (CSA) of the intercostal muscles (ICMs) in patients with COPD, using chest computed tomography (CT) and determined its association with the clinical characteristics of COPD.

Methods: They retrospectively reviewed 60 patients with stable COPD and compared them with 30 controls. CSA (mm2 ) of the ICM on chest CT was measured at the midline level of the lateral arch of the bilateral first rib with a 3-mm slice thickness by using CT histogram software. The association with the clinical characteristics of COPD and with the control groups was assessed.

Results: CSA of the ICM and the CSA/body mass index (BMI) were lower in the COPD group than in the control group. Patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 4 had a significantly lower CSA of the ICM than patients with stage 1, 2, and 3. CSA of the ICM was positively associated with FEV1 , %FEV1 predicted, FEV1 /FVC ratio, and BMI and negatively associated with age. However, there were no associations with PaO2 , PaCO2 , smoking status, 6-minute walk test, frequency of acute exacerbation of COPD, and serum C-reactive protein level.

Conclusion: Intercostal muscle atrophy occurs in COPD patients and is associated with severity of airway obstruction, BMI, and increasing age.

Keywords: COPD; computed tomography; cross sectional area; intercostal muscle.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Body Mass Index
  • C-Reactive Protein / metabolism
  • Cross-Sectional Studies
  • Disease Progression
  • Female
  • Humans
  • Intercostal Muscles / diagnostic imaging*
  • Intercostal Muscles / pathology
  • Intercostal Muscles / physiopathology
  • Male
  • Middle Aged
  • Muscular Atrophy / diagnosis
  • Muscular Atrophy / etiology
  • Muscular Atrophy / pathology*
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / diagnostic imaging*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Republic of Korea / epidemiology
  • Respiratory Function Tests / methods
  • Respiratory Muscles / diagnostic imaging*
  • Respiratory Muscles / physiopathology
  • Retrospective Studies
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Software
  • Tomography, X-Ray Computed / methods
  • Walk Test / methods

Substances

  • C-Reactive Protein