Chest and Abdominal Wall Mobility and Cardiac Size in Older Adults With Heart Failure and Restrictive Spirometric Patterns: A Preliminary Cross-Sectional Study.

backgroundRestrictive spirometric patterns are common in older patients with heart failure (HF), and cardiac enlargement is considered a contributing factor. However, in older adults, reduced chest wall mobility primarily contributes to restrictive spirometric patterns. This preliminary study investigated the relationship of restrictive spirometric patterns with cardiac size and chest and abdominal wall mobility in hospitalized older patients with stable HF.

methodsWe conducted a preliminary cross-sectional study of older patients with stable HF who were hospitalized for an acute exacerbation of HF at Takagi Hospital in Japan, from December 2020 to November 2021. Restrictive spirometric patterns, cardiac size (assessed via cardiothoracic ratio), chest and abdominal wall mobility (evaluated by chest and total scale values of the breathing movement scale), physical performance (measured by the Short Physical Performance Battery), and cognitive function (evaluated by the Revised Hasegawa's Dementia Scale) were examined in 65 hospitalized older patients with HF. The Mann-Whitney U test and Chi-squared test were used to compare patients with and without restrictive spirometric patterns. In addition, univariable and multivariable logistic regression analyses were performed to assess whether cardiothoracic ratio, chest, or total scale values were associated with restrictive spirometric patterns.

resultsTwenty-one patients were excluded (patients with a neurological disease, dementia, or airflow limitation). Of the 44 patients (23 females), 20 had restrictive spirometric patterns. Patients with restrictive spirometric patterns had lower values on the chest and total scales, the Short Physical Performance Battery, and the Revised Hasegawa's Dementia Scale than patients without restrictive spirometric patterns. There were no significant differences between the groups in basic characteristics. Multivariable logistic regression analysis indicated that both the chest and total scale values were significantly associated factors of restrictive spirometric patterns (chest scale: odds ratio = 0.59; 95% confidence interval = 0.39-0.82, total scale: odds ratio = 0.64; 95% confidence interval = 0.45-0.83).

conclusionOur findings suggest that restrictive spirometric patterns may be associated with reduced chest and abdominal wall mobility in hospitalized older patients with stable HF.