• Simone Scarlata, Evelyn Di Matteo, Panaiotis Finamore, Giuseppe Perri, Damiana Mancini, Luigi Sogaro, Tommaso Grandi, Elisa Brando, Francesco Travaglino, Federica Sambuco, and Antonelli IncalziRaffaeleRUnit of Internal Medicine, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200-00128, Rome, Italy.Research Unit of Internal Medicine, Università Campus Bio-Medico di Roma, Rome, Italy..
• Unit of Internal Medicine, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200-00128, Rome, Italy. s.scarlata@policlinicocampus.it.
• Intern Emerg Med. 2024 Apr 1; 19 (3): 705711705-711.

AbstractHeart failure patients often experience respiratory symptoms due to diaphragmatic involvement, but the diaphragmatic motion in heart failure remains understudied. This research aimed to investigate the correlation between ultrasonographically assessed diaphragmatic motion and thickness with cardiac performance indexes in an emergency setting. Seventy-two acutely decompensated heart failure patients and 100 non-heart failure individuals were enrolled. Diaphragmatic motion and thickness were assessed via ultrasound. Cardiac and respiratory parameters were recorded, and regression analysis was performed. Heart failure patients exhibited reduced diaphragmatic motion at total lung capacity compared to controls, and an inverse association was found between motion and heart failure severity (NYHA stage). Diaphragmatic thickness was also higher in heart failure patients at tidal volume and total lung capacity. Notably, diaphragmatic motion inversely correlated with systolic pulmonary artery pressure. The study highlights diaphragmatic dysfunction in acutely decompensated heart failure, with reduced motion and increased thickness. These changes were associated with cardio-respiratory parameters, specifically systolic pulmonary artery pressure. Monitoring diaphragmatic motion via ultrasound may aid in evaluating heart failure severity and prognosis in emergency settings. Additionally, interventions targeting diaphragmatic function could improve heart failure management. Further research is warranted to enhance heart failure management and patient outcomes.© 2024. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).

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