Arm span to height ratio is related to severity of dyspnea, reduced spirometry volumes, and right heart strain.
BACKGROUND
Arm span is the closest physiologic measurement to standing height. Increased arm span to standing height ratio, therefore, indicates possible loss of height, which is a feature of aging, often resulting from osteoporosis-related vertebral collapse. We hypothesize that the discrepancy between arm span and height is associated with reduced airflow volumes, severity of dyspnea, and right-sided cardiac structural changes in older individuals with symptoms of dyspnea.


METHODS
Patients with conditions investigated with transthoracic echocardiography for suspected heart failure were invited to participate in our study. All subjects were evaluated with a clinical history and physical examination followed by measurements of arm span, standing height, weight, FEV(1), and FVC.


RESULTS
Sixty-six subjects aged 71 +/- 10 years were recruited for our study. Arm span to height ratio was significantly negatively correlated with FEV(1) (r = - 0.464; p < 0.001), FVC (r = - 0.479; p < 0.001), and body weight (r = - 0.252; p < 0.05), and positively correlated with the New York Heart Association classification for dyspnea (rho = 0.309; p < 0.05). Female sex, steroid use, inhaled bronchodilators, orthopnea, paroxysmal nocturnal dyspnea, and right heart chamber dilatation were significantly associated with increased arm span to height ratio.


CONCLUSIONS
We have found a significant association between increased arm span to height ratio, reduced respiratory airflow volumes, increased severity of dyspnea, and echocardiographic features of pulmonary heart disease in a group of predominantly elderly subjects with multiple comorbidities. The role of arm span measurements in assessments of airflow volumes in older patients and the association between loss of height and dyspnea now deserve further evaluation.
Institute for Ageing and Health, Newcastle University, Newcastle Upon Tyne, UK. Electronic address: mptan@doctors.org.uk.
Maw P
MP
Tan
Department of Cardiology, City Hospitals Sunderland NHS Trust, Sunderland, UK.
Nu Nu
NN
Wynn
Department of Cardiology, City Hospitals Sunderland NHS Trust, Sunderland, UK.
Murad
M
Umerov
Department of Care of the Elderly, City Hospitals Sunderland NHS Trust, Sunderland, UK.
Alison
A
Henderson
Department of Care of the Elderly, City Hospitals Sunderland NHS Trust, Sunderland, UK.
Angela
A
Gillham
Department of Cardiology, City Hospitals Sunderland NHS Trust, Sunderland, UK.
Shahid
S
Junejo
Department of Care of the Elderly, City Hospitals Sunderland NHS Trust, Sunderland, UK.
Sushil K
SK
Bansal
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D001132:Arm / Q000502:physiology*; D001827:Body Height / Q000502:physiology*; D015331:Cohort Studies; D004417:Dyspnea / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012143:Respiratory Physiological Phenomena; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012737:Sex Factors; D013147:Spirometry / Q000379:methods*; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000209:etiology; D014797:Vital Capacity; D055815:Young Adult