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Heterogeneity of quadriceps muscle phenotype in chronic obstructive pulmonary disease ( Copd ); implications for stratified medicine?
Author(s) -
Natanek Samantha A.,
Gosker Harry R.,
Slot Ilse G.M.,
Marsh Gemma S.,
Hopkinson Nicholas S.,
Man William D.C.,
TalSinger Ruth,
Moxham John,
Kemp Paul R.,
Schols Annemie M.W.J.,
Polkey Michael I.
Publication year - 2013
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.23784
Subject(s) - copd , medicine , muscle biopsy , atrophy , muscle atrophy , biopsy , thigh , pulmonary disease , cardiology , quadriceps muscle , pathology , gastroenterology , anatomy
Quadriceps muscle dysfunction is common in COPD. Determining, and, if possible, predicting quadriceps phenotype in COPD is important for patient stratification for therapeutic trials. Methods In biopsies from 114 COPD patients and 30 controls, we measured fiber size and proportion and assessed the relationship with quadriceps function (strength and endurance), clinical phenotype (lung function, physical activity, fat‐free mass) and exercise performance. In a subset ( n = 40) we measured muscle mid‐thigh cross‐sectional area by computed tomography. Results Normal ranges for fiber proportions and fiber cross‐sectional area were defined from controls; we found isolated fiber shift in 31% of patients, isolated fiber (predominantly type II) atrophy in 20%, both shift and atrophy in 25%, and normal fiber parameters in 24%. Clinical parameters related poorly to muscle biopsy appearances. Conclusions Quadriceps morphology is heterogeneous in COPD and cannot be predicted without biopsy, underlining the need for biomarkers. Muscle Nerve 48 : 488–497, 2013