Am. J. Respir. Crit. Care Med., Vol 155, No. 3, Mar 1997, 1110-1116.
Diaphragm muscle fiber injury after inspiratory resistive breathing
E Zhu, BJ Petrof, J Gea, N Comtois and AE Grassino
Hopital Notre-Dame, University de Montreal, Quebec, Canada.
Five awake previously tracheotomized mongrel dogs were challenged with
inspiratory resistive breathing (IRB). The mean peak tracheal pressure =
-35.4 +/- 1.1 cmH2O, ETCO2 = 39.8 +/- 1.5 mmHg was sustained for 2 h/d over
4 consecutive d. On the fourth day, following IRB, the dogs were placed
under general anaesthesia, and the diaphragm was perfused via the internal
mammary artery with a low molecular weight fluorescent tracer (Procion
orange, FW = 631), to which normal muscle fibers are impermeable. Muscle
fiber membrane damage was identified on tissue sections by using
fluorescent microscopy showing the presence of the tracer in the cytoplasm.
Four dogs undergoing the same protocol (except IRB) served as control. The
dye was seen in 7.6 +/- 2.6% and in 0.3 +/- 0.1% of fibers in the IRB and
control groups, respectively (p < 0.05). Via ATPase staining, it was
found that fibers of type I were predominantly affected as compared to type
II (p < 0.05). In addition, an increased area fraction of fibers
demonstrating sarcomere disruption was found after IRB (2.4 +/- 0.5%)
compared to pre-IRB (0.4 +/- 0.1%; p < 0.05). We conclude that resistive
breathing of a magnitude similar to that seen in some respiratory diseases,
or used in respiratory muscle training programs induces muscle membrane and
sarcomere injury.
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Copyright © 1997 American Thoracic Society
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