ArticleRespiratory research2008
Diaphragm adaptations in patients with COPD.
Article in Respiratory research, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
63 citing papers in PubMed, 6 syntheses or guidelines pooled it, 152 citations in OpenAlex.
- The Impact of Inspiratory Muscle Training on Diaphragm Thickness in Healthy Adults: A Systematic Review and Meta-Regression.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Respiratory Muscle Strength and Mortality in Patients with COPD: A Systematic Review and Meta-Analysis.International journal of chronic obstructive pulmonary disease · 2025Pooled it
- Inspiratory muscle training, with or without concomitant pulmonary rehabilitation, for chronic obstructive pulmonary disease (COPD).The Cochrane database of systematic reviews · 2023Pooled it
- Chronic non-invasive ventilation for chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2021Pooled it
- Rehabilitation Effects of Acupuncture on the Diaphragm Dysfunction in Chronic Obstructive Pulmonary Disease: A Systematic Review.International journal of chronic obstructive pulmonary disease · 2021Pooled it
- Diagnostic and clinical values of non-cardiac ultrasound in COPD: A systematic review.BMJ open respiratory research · 2020Pooled it
- Transcranial direct current stimulation's effect on exercise capacity, respiratory muscle strength, and physical performance in patients with chronic obstructive pulmonary disease: Randomized controlled trial.Chronic respiratory diseaseTrial
- Identifying key diaphragm ultrasound predictors for early screening of respiratory sarcopenia.Scientific reports · 2026Article
- Mechanical Forces and Mechanotransduction in COPD: Pathogenesis, Clinical Phenotypes, and Therapeutic Implications.International journal of chronic obstructive pulmonary disease · 2026Review
- Intra- and Inter-examiner Reliability of Diaphragmatic Ultrasound Parameters in People with Stable Chronic Obstructive Pulmonary Disease.Physical therapy research · 2026Article
- Inspiratory muscle training in the healthy adult: The relationship between load, perception, and oxygen consumption.Clinical physiology and functional imaging · 2026Article
- Ultrasound Assessment of Diaphragm in Patients with Chronic Obstructive Pulmonary Disease, Interstitial Lung Disease and Healthy Volunteers: An Observational Study.JNMA; journal of the Nepal Medical Association · 2025Observational
- Leptin and Insulin in COPD: Unveiling the Metabolic-Inflammatory Axis-A Narrative Review.Journal of clinical medicine · 2025Review
- Automated CT-based measurements of radial and longitudinal expansion of airways due to breathing-related lung volume change.Medical physics · 2025Article
- Physiological effects and clinical evidence of high-flow nasal cannula during acute exacerbation in COPD patients: A narrative review.Journal of intensive medicine · 2025Review
- Automated evaluation of diaphragm configuration based on chest CT in COPD patients.European radiology experimental · 2024Article
- Review
- CT-derived pectoralis composition and incident pneumonia hospitalization using fully automated deep-learning algorithm: multi-ethnic study of atherosclerosis.European radiology · 2024Article
- Diaphragm and Lung Transplantation.Transplant international : official journal of the European Society for Organ Transplantation · 2024Review
- Myogenesis Effects of RGX365 to Improve Skeletal Muscle Atrophy.Nutrients · 2023Article
3 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Inspiratory muscle weakness in patients with COPD is of major clinical relevance. For instance, maximum inspiratory pressure generation is an independent determinant of survival in severe COPD. Traditionally, inspiratory muscle weakness has been ascribed to hyperinflation-induced diaphragm shortening. However, more recently, invasive evaluation of diaphragm contractile function, structure, and biochemistry demonstrated that cellular and molecular alterations occur, of which several can be considered pathologic of nature. Whereas the fiber type shift towards oxidative type I fibers in COPD diaphragm is regarded beneficial, rendering the overloaded diaphragm more resistant to fatigue, the reduction of diaphragm fiber force generation in vitro likely contributes to diaphragm weakness. The reduced diaphragm force generation at single fiber level is associated with loss of myosin content in these fibers. Moreover, the diaphragm in COPD is exposed to oxidative stress and sarcomeric injury. This review postulates that the oxidative stress and sarcomeric injury activate proteolytic machinery, leading to contractile protein wasting and, consequently, loss of force generating capacity of diaphragm fibers in patients with COPD. Interestingly, several of these presumed pathologic alterations are already present early in the course of the disease (GOLD I/II), although these patients appear not limited in their daily life activities. Treatment of diaphragm dysfunction in COPD is complex since its etiology is unclear, but recent findings indicate the ubiquitin-proteasome pathway as a prime target to attenuate diaphragm wasting in COPD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.