Hamo-Study 3, Phase 1: Effects Of Sternotomy On The Mobility Of The Heart
Under Influence Of Respiration At 3 Months Postoperative
Roncada Gert1,3, Bijnens Erik2, Dendale Paul1
Introduction: The heart is subject to certain changes of position under influence of respiration.
HaMo-Study 1 has shown and objectified this movement. Other studies up to 1 year
postoperative state that there is an decrease of thoracic mobility and inspiratory capacity.
Aim: HaMo-Study 3 wants to examine whether this mobility of the heart is influenced after
sternotomy for coronary arterial bypass graft (CABG). It is a comparative study.
Methods: The Achieva 1.5 (magnetic resonance) has been used. In order to obtain a good
three-dimensional image, localizer images were made in the three orthogonal planes. After this
images were made in the long axis (two-chamber view), short axis and four-chamber view.
Images were made in expiration, inspiration and in neutral position using ECG-triggering. Vital
capacity was measured with Pocket-Spiro USB100. In total there are 18 test subjects wich were
3 months post-operative, and 13 controls.
Results: As we already know (HaMo-Study 1), the heart undergoes a distinct change of position
under influence of respiration. The apex shifts to caudal, right and anterior. A significant
decrease in mobility of the apex cordis in the three orthogonal planes is shown in the operated
group compared with the healthy test subjects. There was no significant difference in vital
capacity and age between the groups. A one-way ANOVA post-hoc test was used.
Tabel: movement of the apex cordis by inhalation (sig. at .05 level)
Conclusions: The usual respiratory movement of the heart is significantly reduced by median
sternotomy at three months postoperative. Phase 2 of HaMo-Study 3 will test the subjects at 12
months postoperative to study the natural evolution of these changes. The OstImCare study has
been started to examine whether osteopathic treatment can influence these changes.
| |
Caudal |
Right |
Anterior |
| Healthy (n=13) |
23.38 mm |
14.22 mm |
17.65 mm |
| Sternotomy (n=18) |
9.55 mm |
5.43 mm |
11.51 mm |
| p-value |
0.000 |
0.001 |
0.015 |
1 Virga Jesse Hospital, department of cardiology, Hasselt (Belgium)
2 Virga Jesse Hospital, department of radiology, Hasselt (Belgium)
3 Commission for Osteopathic Research, Practice and Promotion vzw (CORPP, Belgium)
