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Original Research: DYSPNEA |

Arm Span to Height Ratio Is Related to Severity of Dyspnea, Reduced Spirometry Volumes, and Right Heart Strain

Maw P. Tan, MRCP; Nu Nu Wynn, MBBS; Murad Umerov, MRCP; Alison Henderson, RN; Angela Gillham, RN; Shahid Junejo, FRCP; Sushil K. Bansal, FRCP
Author and Funding Information

*From the Institute for Ageing and Health (Dr. Tan), Newcastle University, Newcastle Upon Tyne, UK; and the Department of Cardiology (Drs. Wynn, Umerov, and Junejo) and the Department of Care of the Elderly (Ms. Henderson, Ms. Gillham, and Dr. Bansal), City Hospitals Sunderland NHS Trust, Sunderland, UK.

Correspondence to: Maw P. Tan, MRCP, Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle University, Newcastle Upon Tyne, UK, NE4 5PL; e-mail: mptan@doctors.org.uk


Dr. Junejo has received travel grants and honoraria from Boston-Scientific, Cordis, Sanofi-Aventis to attend educational meetings and as a speaker to primary care physicians. He also served on an advisory board for Sanofi-Aventis in 2007. The other authors have no conflicts of interest to disclose. This project was funded by a research grant from the British Geriatrics Society. Dr. Tan's salary is currently funded by the Royal College of Physicians/ Dunhill Medical Trust Joint Research Fellowship.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2009;135(2):448-454. doi:10.1378/chest.08-1270
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Background:  Arm span is the closest physiologic measurement to standing height. Increased arm span to standing height ratio, therefore, indicates possible loss of height, which is a feature of aging, often resulting from osteoporosis-related vertebral collapse. We hypothesize that the discrepancy between arm span and height is associated with reduced airflow volumes, severity of dyspnea, and right-sided cardiac structural changes in older individuals with symptoms of dyspnea.

Method:  Patients with conditions investigated with transthoracic echocardiography for suspected heart failure were invited to participate in our study. All subjects were evaluated with a clinical history and physical examination followed by measurements of arm span, standing height, weight, FEV1, and FVC.

Results:  Sixty-six subjects aged 71 ± 10 years were recruited for our study. Arm span to height ratio was significantly negatively correlated with FEV1 (r = − 0.464; p < 0.001), FVC (r = − 0.479; p < 0.001), and body weight (r = − 0.252; p < 0.05), and positively correlated with the New York Heart Association classification for dyspnea (ρ = 0.309; p < 0.05). Female sex, steroid use, inhaled bronchodilators, orthopnea, paroxysmal nocturnal dyspnea, and right heart chamber dilatation were significantly associated with increased arm span to height ratio.

Conclusion:  We have found a significant association between increased arm span to height ratio, reduced respiratory airflow volumes, increased severity of dyspnea, and echocardiographic features of pulmonary heart disease in a group of predominantly elderly subjects with multiple comorbidities. The role of arm span measurements in assessments of airflow volumes in older patients and the association between loss of height and dyspnea now deserve further evaluation.

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