Journal
MUSCLE & NERVE
Volume 48, Issue 4, Pages 488-497Publisher
WILEY
DOI: 10.1002/mus.23784
Keywords
COPD; fiber atrophy; fiber shift; muscle biopsy; muscle histology; quadriceps
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Funding
- NIHR Respiratory Biomedical Research Unit at the Royal Brompton Hospital and Imperial College, London UK
- Wellcome Clinical Fellowship [079686]
- Netherlands Asthma Foundation [NAF 3.4.09.068]
- National Institute for Health Research Clinician Scientist Award [CS/7/2007]
- Medical Research Council New Investigator Research Grant [G1002113]
- NIHR Respiratory Biomedical Research Unit at the Royal Brompton Hospital and Imperial College
- GSK
- MRC [G1002113] Funding Source: UKRI
- Medical Research Council [G1002113] Funding Source: researchfish
- National Institute for Health Research [CTF-01-12-04, DHCS/07/07/009] Funding Source: researchfish
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Introduction: Quadriceps muscle dysfunction is common in COPD. Determining, and, if possible, predicting quadriceps phenotype in COPD is important for patient stratification for therapeutic trials. Methods: In biopsies from 114 COPD patients and 30 controls, we measured fiber size and proportion and assessed the relationship with quadriceps function (strength and endurance), clinical phenotype (lung function, physical activity, fat-free mass) and exercise performance. In a subset (n=40) we measured muscle mid-thigh cross-sectional area by computed tomography. Results: Normal ranges for fiber proportions and fiber cross-sectional area were defined from controls; we found isolated fiber shift in 31% of patients, isolated fiber (predominantly type II) atrophy in 20%, both shift and atrophy in 25%, and normal fiber parameters in 24%. Clinical parameters related poorly to muscle biopsy appearances. Conclusions: Quadriceps morphology is heterogeneous in COPD and cannot be predicted without biopsy, underlining the need for biomarkers.
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