Investigating the influence of Chronic Obstructive Pulmonary Disease severity on the thickness of the Diaphragm Muscle

Authors

  • Humaira Gulnaz Department of Anatomy, Fatima Medical University, Lahore - Pakistan
  • Munazza Sardar Department of Anatomy, Allama Iqbal Medical College, Lahore – Pakistan
  • Syeda Rizwana Jafri Department of Anatomy, Gujranwala Medical College, Gujranwala – Pakistan
  • Syeda Zakia Department of Anatomy, Azra Naheed Medical College, Lahore - Pakistan
  • Kanwal Saeed Department of Anatomy, Ameerudin Medical College, Lahore - Pakistan

Keywords:

COPD, Diaphragm Thickness, Ultrasound, FEV₁, GOLD Stages

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease that is defined by airflow limitation and diaphragm respiratory muscle dysfunction. Diaphragm thickness and contractility, which can be quantified by ultrasound, are extremely informative regarding respiratory muscle function. Objective: To assess the effect of COPD severity on diaphragm muscle thickness and its correlation with clinical and functional parameters. Methods: Cross-sectional observational study was performed on 240 COPD patients, as per the GOLD staging system divided into four groups (GOLD I–IV; n = 60 each). Thickness of the diaphragm at end-expiration (Texp) and end-inspiration (Tinsp), and thickening fraction of the diaphragm (TF%) were measured by B-mode ultrasonography. Pulmonary function tests (FEVâ‚, FVC, FEVâ‚/FVC), symptom scores (mMRC), and anthropometric measures (age, BMI, smoking history, COPD duration) were ascertained. Results: Significant reduction in diaphragm thickness and TF% with increasing severity of COPD (p < 0.001 for all). Texp and Tinsp significantly reduced from GOLD I to GOLD IV (Texp: 2.6 ± 0.4 mm to 1.7 ± 0.2 mm; Tinsp: 4.3 ± 0.6 mm to 2.6 ± 0.3 mm). TF% also reduced significantly (65.4 ± 12.2% in GOLD I compared to 50.1 ± 8.4% in GOLD IV). High positive correlations were found between diaphragm parameters and FEVâ‚ (Texp: r = 0.51; Tinsp: r = 0.56; TF%: r = 0.48; all p < 0.001). Conclusion: Diaphragm thickening and thickening fraction diminish substantially with severity of COPD. Both measurements strongly correlate with pulmonary function and are independently affected by FEVâ‚, BMI, disease duration, and age.

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Published

2025-07-13

How to Cite

Gulnaz, H. ., Sardar, M. ., Jafri, S. R. ., Zakia, S. ., & Saeed, K. . (2025). Investigating the influence of Chronic Obstructive Pulmonary Disease severity on the thickness of the Diaphragm Muscle. Pakistan Journal of Chest Medicine, 30(2), 203–210. Retrieved from http://www.pjcm.net/index.php/pjcm/article/view/964

Issue

Vol. 30 No. 2 (2024)

Section

Original Article

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