title: Study of breathing pattern and thoracoabdominal movement in mitral valve disease.
abstract: BACKGROUND
  patients with mitral valve disease can progress to having pulmonary congestion, which increases the work the respiratory muscles. This overload can change the breathing pattern with a predominance of rib cage displacement or presence of paradoxical movements.
  
  
  OBJECTIVE
  a) to study the breathing pattern and thoracoabdominal movement of patients with mitral valve disease; b) to study the effect of body position on breathing parameters; and c) to correlate pulmonary hypertension with lack of coordination of thoracoabdominal movement.
  
  
  METHODS
  the breathing pattern and thoracoabdominal movement of patients with mitral valve disease were assessed using respiratory inductive plethysmography during quiet breathing in the dorsal decubitus and sitting positions for two minutes. The variables assessed were tidal volume, breathing time and thoracoabdominal movement.
  
  
  RESULTS
  of the 65 patients selected, 10 were excluded, 29 were in the mitral stenosis group and 26 in the mitral regurgitation group. Tidal volume, pulmonary ventilation and mean inspiratory flow significantly increased in the sitting position, with no difference between the groups. The thoracoabdominal movement remained coordinated in all groups and positions; except for five patients in the dorsal decubitus position, who lacked coordination (three in the mitral stenosis group; two in the mitral regurgitation group). A significant correlation with pulmonary artery pressure values was observed (r = 0.992; p = 0.007).
  
  
  CONCLUSIONS
  No difference in breathing pattern or thoracoabdominal movement was found between patients with mitral stenosis and regurgitation. The sitting position increased tidal volume without altering breathing times. The lack of coordination of the thoracoabdominal movement in the dorsal decubitus position was associated with pulmonary hypertension.
authors.affiliation: Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brasil.
authors.forename: Satiko Shimada
authors.initials: SS
authors.lastname: Franco
authors.forename: Paula Nubiato
authors.initials: PN
authors.lastname: Bardi
authors.forename: Max
authors.initials: M
authors.lastname: Grinberg
authors.forename: Maria Ignêz Zanetti
authors.initials: MI
authors.lastname: Feltrim
mesh_terms: D000005:Abdomen / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000886:Anthropometry; D001944:Breath Tests; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology*; D008944:Mitral Valve Insufficiency / Q000503:physiopathology*; D008946:Mitral Valve Stenosis / Q000503:physiopathology*; D010991:Plethysmography; D012119:Respiration; D012132:Respiratory Muscles / Q000503:physiopathology*; D013909:Thorax / Q000503:physiopathology; D055815:Young Adult