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01.10.2015 | Original Paper

Biological variation, reference change value (RCV) and minimal important difference (MID) of inspiratory muscle strength (PImax) in patients with stable chronic heart failure

verfasst von: Tobias Täger, Miriam Schell, Rita Cebola, Hanna Fröhlich, Andreas Dösch, Jennifer Franke, Hugo A. Katus, Frank H. Wians Jr., Lutz Frankenstein

Erschienen in: Clinical Research in Cardiology | Ausgabe 10/2015

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Abstract

Background

Despite the widespread application of measurements of respiratory muscle force (PI_max) in clinical trials there is no data on biological variation, reference change value (RCV), or the minimal important difference (MID) for PI_max irrespective of the target cohort. We addressed this issue for patients with chronic stable heart failure.

Methods and results

From the outpatients’ clinic of the University of Heidelberg we retrospectively selected three groups of patients with stable systolic chronic heart failure (CHF). Each group had two measurements of PI_max: 90 days apart in Group A (n = 25), 180 days apart in Group B (n = 93), and 365 days apart in Group C (n = 184). Stability was defined as (a) no change in NYHA class between visits and (b) absence of cardiac decompensation 3 months prior, during, and 3 months after measurements. For each group, we determined within-subject (CV_I), between-subject (CV_G), and total (CV_T) coefficient of variation (CV), the index of individuality (II), RCV, reliability coefficient, and MID of PI_max. CV_T was 8.7, 7.5, and 6.9 % for groups A, B, and C, respectively. The II and RCV were 0.21, 0.20, 0.16 and 13.6, 11.6, 10.8 %, respectively. The reliability coefficient and MID were 0.83, 0.87, 0.88 and 1.44, 1.06, 1.12 kPa, respectively. Results were similar between age, gender, and aetiology subgroups.

Conclusion

In patients with stable CHF, measurements of PI_max are highly stable for intervals up to 1 year. The low values for II suggest that evaluation of change in PI_max should be performed on an individual (per patient) basis. Individually significant change can be assumed beyond 14 % (RCV) or 1.12 kPa (MID).

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Titel: Biological variation, reference change value (RCV) and minimal important difference (MID) of inspiratory muscle strength (PImax) in patients with stable chronic heart failure
verfasst von: Tobias Täger
Miriam Schell
Rita Cebola
Hanna Fröhlich
Andreas Dösch
Jennifer Franke
Hugo A. Katus
Frank H. Wians Jr.
Lutz Frankenstein
Publikationsdatum: 01.10.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Research in Cardiology / Ausgabe 10/2015
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-015-0850-3

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Biological variation, reference change value (RCV) and minimal important difference (MID) of inspiratory muscle strength (PImax) in patients with stable chronic heart failure