Diaphragm Dysfunction Is Common in Asthma and Linked to Disease Severity, finds study

A new study published in Respiratory Medicine has found that diaphragm dysfunction is more common in asthma patients and is associated with worse disease outcomes, including higher rates of exacerbation and longer disease duration. Asthma, a chronic inflammatory airway condition, has been known to impair lung function and exercise capacity. This study was conducted by Andrea P. and colleagues.

The research enrolled 50 asthma patients and 50 healthy controls in a prospective, observational study of diaphragmatic function. Two separate operators measured diaphragm contraction with tidal breathing thickening fraction (TF), dysfunction being TF < 20%. Other evaluations performed were flow-volume spirometry, impulse oscillometry (IOS), fractional exhaled nitric oxide (FeNO), blood eosinophil count, and Sniff Inspiratory Nasal Pressure (SNIP) testing.

Key Findings

  • Asthmatic patients had greatly reduced diaphragm TF levels than healthy controls (p < 0.0001).

  • 62%–66% of right hemidiaphragm and 46%–54% of left hemidiaphragm cases had diaphragm dysfunction.

  • Decreased diaphragm TF was associated with increased disease duration (p = 0.03) and increased rates of exacerbation (p = 0.04).

  • There were no correlations between diaphragm TF and lung function, Th2 markers, anthropometry, or treatments for asthma.

  • No correlation existed between SNIP test results and diaphragm TF.

  • The cross-sectional design and small sample size of the study were listed as limitations.

The study authors concluded that diaphragm dysfunction is common in asthma and correlates with disease severity, including increased exacerbation frequency and longer disease duration. Identifying and addressing diaphragm impairment may improve symptom management and overall quality of life in asthma patients.

Reference:

Portacci, A., Iorillo, I., Quaranta, V. N., Amendolara, M., Sana, F., Pezzuto, V., Ferrulli, S., Dragonieri, S., & Carpagnano, G. E. (2025). Diaphragm function in patients with asthma and healthy controls: a cross-sectional study. Respiratory Medicine, 108008, 108008. https://doi.org/10.1016/j.rmed.2025.108008

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