Assessment of proximal and peripheral airway dysfunction by computed tomography and respiratory impedance in asthma and COPD patients with fixed airflow obstruction
| Autor: | Chayanin Nitiwarangkul, Theerasuk Kawamatawong, Wasana Thaipisuttikul, Thitiporn Suwatanapongched, Kittipong Maneechotesuwan, Prapaporn Pornsuriyasak, Naparat Amornputtisathaporn |
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| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
lcsh:Diseases of the circulatory (Cardiovascular) system medicine.medical_specialty Air trapping 03 medical and health sciences 0302 clinical medicine Internal medicine medicine respiratory impedance Lung volumes 030212 general & internal medicine impulse oscillometry Asthma lcsh:RC705-779 Body surface area COPD expiratory air trapping Airway wall thickness business.industry lcsh:Diseases of the respiratory system respiratory system medicine.disease airway lumen area respiratory tract diseases Peripheral Impulse Oscillometry 030228 respiratory system lcsh:RC666-701 Cardiology Original Article Surgery medicine.symptom Cardiology and Cardiovascular Medicine business Airway |
| Zdroj: | Annals of Thoracic Medicine Annals of Thoracic Medicine, Vol 13, Iss 4, Pp 212-219 (2018) |
| ISSN: | 1817-1737 |
| Popis: | OBJECTIVE: To ascertain: (i) if elderly patients with fixed airflow obstruction (FAO) due to asthma and chronic obstructive pulmonary disease (COPD) have distinct airway morphologic and physiologic changes; (ii) the correlation between the morphology of proximal/peripheral airways and respiratory impedance. METHODS: Twenty-five asthma cases with FAO and 22 COPD patients were enrolled. High-resolution computed tomography was used to measure the wall area (WA) and lumen area (LA) of the proximal airway at the apical segmental bronchus of the right upper lobe (RB1) adjusted by body surface area (BSA) and bronchial wall thickening (BWTr) of the peripheral airways and extent of expiratory air trapping (ATexp). Respiratory impedance included resistance at 5 Hz (R5) and 20 Hz (R20) and resonant frequency (Fres). Total lung capacity (TLC) and residual volume (RV) were measured. RESULTS: Asthma patients had smaller RB1-LA/BSA than COPD patients (10.5 ± 3.4 vs. 13.3 ± 5.0 mm2/m2, P = 0.037). R5 (5.5 ± 2.0 vs. 3.4 ± 1.0 cmH2O/L/s, P = 0.02) and R20(4.2 ± 1.7 vs. 2.6 ± 0.7 cmH2O/L/s, P = 0.001) were higher in asthma cases. ATexp and BWTr were similar in both groups. Regression analysis in asthma showed that forced expiratory volume in one second (FEV1) and Fres were associated with RB1-WA/BSA (R2 = 0.34, P = 0.005) and BWTr (0.5, 0.012), whereas RV/TLC was associated with ATexp (0.38, 0.001). CONCLUSIONS: Asthma patients with FAO had a smaller LA and higher resistance of the proximal airways than COPD patients. FEV1 and respiratory impedance correlated with airway morphology. |
| Databáze: | OpenAIRE |
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