Open AccessPreliminary investigation of cardiopulmonary function in stroke patients with stable heart failure and exertional dyspnea
Author(s) -
Mei-Yun Liaw,
Lin-Yi Wang,
Ya-Ping Pong,
Yu-Chin Tsai,
YuChi Huang,
TsungHsun Yang,
MengChih Lin
Publication year - 2016
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000005071
Subject(s) - medicine , vital capacity , spirometry , heart failure , cardiology , stroke (engine) , heart rate , pulmonary function testing , stroke volume , physical therapy , blood pressure , ejection fraction , lung function , lung , asthma , diffusing capacity , mechanical engineering , engineering
The aim of this study was to investigate the relationships between pulmonary function, respiratory muscle strength, perceived dyspnea, degree of fatigue, and activity of daily living with motor function and neurological status in stroke patients with stable congestive heart failure (CHF). This was a cohort study in a tertiary care medical center. Stroke patients with CHF and exertional dyspnea (New York Heart Association class I–III) were recruited. The baseline characteristics included duration of disease, Brunnstrom stage, spirometry, resting heart rate, resting oxyhemoglobin saturation (SpO 2 ), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), Borg scale, fatigue scale, and Barthel index. A total of 47 stroke patients (24 males, 23 females, mean age 65.9 ± 11.5 years) were included. The average Brunnstrom stages of affected limbs were 3.6 ± 1.3 over the proximal parts and 3.5 ± 1.4 over the distal parts of upper limbs, and 3.9 ± 0.9 over lower limbs. The average forced vital capacity (FVC) was 2.0 ± 0.8 L, with a predicted FVC% of 67.9 ± 18.8%, forced expiratory volume in the first second (FEV 1 ) of 1.6 ± 0.7 L, predicted FEV 1 % of 70.6 ± 20.1%, FEV 1 /FVC of 84.2 ± 10.5%, and maximum mid-expiratory flow of 65.4 ± 29.5%. The average MIP and MEP were −52.9 ± 33.3 cmH 2 O and 60.8 ± 29.0 cmH 2 O, respectively. The Borg scale was 1.5 ± 0.8. MIP was negatively associated with the average Brunnstrom stage of the proximal ( r = −0.318, P < 0.05) and distal (r = −0.391, P < 0.01) parts of the upper extremities and lower extremities ( r = −0.288, P < 0.05), FVC ( r = −0.471, P < 0.01), predicted FVC% ( r = −0.299, P < 0.05), and FEV 1 ( r = −0.397, P < 0.01). MEP was positively associated with average Brunnstrom stage of the distal area of the upper extremities ( r = 0.351, P < 0.05), FVC ( r = 0.526, P < 0.01), FEV 1 ( r = 0.429, P < 0.01), and FEV 1 /FVC ( r = −0.482, P < 0.01). FEV 1 /FVC was negatively associated with the average Brunnstrom stage over the proximal ( r = −0.414, P < 0.01) and distal ( r = −0.422, P < 0.01) parts of the upper extremities and lower extremities ( r = −0.311, P < 0.05) and Barthel index ( r = −0.313, P < 0.05). Stroke patients with stable CHF and exertional dyspnea had restrictive lung disorder and respiratory muscle weakness, which were associated with the neurological status of the affected limbs. FVC was more strongly associated with MIP and MEP than predicted FVC%. FEV 1 /FVC may be used as a reference for the pulmonary dysfunction.