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Expiratory and inspiratory resistance and reactance from respiratory oscillometry defining expiratory flow limitation in obstructive lung diseases

Nasr, Abir LU ; Papapostolou, Georgia LU orcid ; Jarenbäck, Linnea LU ; Romberg, Kerstin LU ; Tunsäter, Alf LU ; Ankerst, Jaro LU orcid ; Bjermer, Leif LU and Tufvesson, Ellen LU (2024) In Clinical Physiology and Functional Imaging
Abstract

Background: Expiratory flow limitation (EFL) during tidal breathing and lung hyperinflation have been identified as major decisive factors for disease status, prognosis and response to therapy in obstructive lung diseases. Aim: To investigate the delta values between expiratory and inspiratory resistance and reactance, measured using respiratory oscillometry and its correlation with air trapping and symptoms in subjects with obstructive lung diseases. Methods: Four hundred and seventy-one subjects (96 with chronic obstructive pulmonary disease [COPD], 311 with asthma, 30 healthy smokers and 34 healthy subjects) were included. Spirometry, body plethysmography and respiratory oscillometry measurements were performed and the differences... (More)

Background: Expiratory flow limitation (EFL) during tidal breathing and lung hyperinflation have been identified as major decisive factors for disease status, prognosis and response to therapy in obstructive lung diseases. Aim: To investigate the delta values between expiratory and inspiratory resistance and reactance, measured using respiratory oscillometry and its correlation with air trapping and symptoms in subjects with obstructive lung diseases. Methods: Four hundred and seventy-one subjects (96 with chronic obstructive pulmonary disease [COPD], 311 with asthma, 30 healthy smokers and 34 healthy subjects) were included. Spirometry, body plethysmography and respiratory oscillometry measurements were performed and the differences between the expiratory and inspiratory respiratory oscillometry values (as delta values) were calculated. Questionnaires regarding symptoms and quality of life were administered. Results: Patients with COPD and healthy smokers had an increased delta resistance at 5 Hz (R5) compared with patients with asthma (p < 0.0001 and p = 0.037, respectively) and healthy subjects (p = 0.0004 and p = 0.012, respectively). Patients with COPD also had higher values of ΔR5–R19 than healthy subjects (p = 0.0001) and patients with asthma (p < 0.0001). Delta reactance at 5 Hz (X5) was significantly more impaired in COPD patients than in asthma and healthy subjects (p < 0.0001 for all). There was a correlation between the ratio of residual volume and total lung capacity and ΔR5 (p = 0.0047; r = 0.32), ΔR5–R19 (p = 0.0002; r = 0.41) and ΔX5 (p < 0.0001; r = −0.44), for all subjects. ΔX5 correlated with symptoms in COPD, healthy smokers and patients with asthma. In addition, ΔR5 correlated with asthma symptoms. Conclusion: EFL was most prominent in parameters measuring peripheral resistance and reactance and correlated with air trapping and airway symptoms.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
in press
subject
keywords
airflow limitation, airway obstruction, asthma, COPD, smoker
in
Clinical Physiology and Functional Imaging
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:38873744
  • scopus:85196097911
ISSN
1475-0961
DOI
10.1111/cpf.12895
language
English
LU publication?
yes
id
e07f2f28-b5f6-4cbb-83f0-82e353350b84
date added to LUP
2024-09-09 10:58:22
date last changed
2024-09-10 03:00:18
@article{e07f2f28-b5f6-4cbb-83f0-82e353350b84,
  abstract     = {{<p>Background: Expiratory flow limitation (EFL) during tidal breathing and lung hyperinflation have been identified as major decisive factors for disease status, prognosis and response to therapy in obstructive lung diseases. Aim: To investigate the delta values between expiratory and inspiratory resistance and reactance, measured using respiratory oscillometry and its correlation with air trapping and symptoms in subjects with obstructive lung diseases. Methods: Four hundred and seventy-one subjects (96 with chronic obstructive pulmonary disease [COPD], 311 with asthma, 30 healthy smokers and 34 healthy subjects) were included. Spirometry, body plethysmography and respiratory oscillometry measurements were performed and the differences between the expiratory and inspiratory respiratory oscillometry values (as delta values) were calculated. Questionnaires regarding symptoms and quality of life were administered. Results: Patients with COPD and healthy smokers had an increased delta resistance at 5 Hz (R5) compared with patients with asthma (p &lt; 0.0001 and p = 0.037, respectively) and healthy subjects (p = 0.0004 and p = 0.012, respectively). Patients with COPD also had higher values of ΔR5–R19 than healthy subjects (p = 0.0001) and patients with asthma (p &lt; 0.0001). Delta reactance at 5 Hz (X5) was significantly more impaired in COPD patients than in asthma and healthy subjects (p &lt; 0.0001 for all). There was a correlation between the ratio of residual volume and total lung capacity and ΔR5 (p = 0.0047; r = 0.32), ΔR5–R19 (p = 0.0002; r = 0.41) and ΔX5 (p &lt; 0.0001; r = −0.44), for all subjects. ΔX5 correlated with symptoms in COPD, healthy smokers and patients with asthma. In addition, ΔR5 correlated with asthma symptoms. Conclusion: EFL was most prominent in parameters measuring peripheral resistance and reactance and correlated with air trapping and airway symptoms.</p>}},
  author       = {{Nasr, Abir and Papapostolou, Georgia and Jarenbäck, Linnea and Romberg, Kerstin and Tunsäter, Alf and Ankerst, Jaro and Bjermer, Leif and Tufvesson, Ellen}},
  issn         = {{1475-0961}},
  keywords     = {{airflow limitation; airway obstruction; asthma; COPD; smoker}},
  language     = {{eng}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Clinical Physiology and Functional Imaging}},
  title        = {{Expiratory and inspiratory resistance and reactance from respiratory oscillometry defining expiratory flow limitation in obstructive lung diseases}},
  url          = {{http://dx.doi.org/10.1111/cpf.12895}},
  doi          = {{10.1111/cpf.12895}},
  year         = {{2024}},
}