Document Detail


Airway distensibility and volume recruitment with lung inflation in COPD.
MedLine Citation:
PMID:  20651219     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effects of full lung inflation on respiratory conductance (Grs) and reactance (Xrs) were measured in 15 subjects with moderate to severe chronic obstructive pulmonary disease (COPD) and 11 matched healthy control subjects. Airway distensibility was estimated from the ratio of the difference of Grs between functional residual capacity and total lung capacity to the relevant changes in lung volume (ΔGrs/ΔVl) or transpulmonary pressure (ΔGrs/ΔPtp). Similar analysis was applied to Xrs to estimate lung volume recruitment (ΔXrs/ΔVl or ΔXrs/ΔPtp). The extent of emphysema in COPD subjects was estimated from the percentage of low attenuation area (LAA) at high-resolution computed tomography. At baseline, ΔGrs/ΔVl and ΔXrs/ΔVl were significantly less in COPD than control subjects, indicating less distensibility and volume recruitment in the former. In COPD, ΔGrs/ΔPtp and ΔXrs/ΔPtp were uncorrelated with LAA but correlated with 1-s forced expiratory volume and with each other. After albuterol, both ΔGrs/ΔPtp and ΔGrs/ΔVl became significantly and negatively correlated with LAA, while ΔXrs/ΔPtp and ΔXrs/ΔVl decreased significantly independently of LAA. Moreover, ΔGrs/ΔPtp and ΔXrs/ΔPtp with lung inflation were no longer correlated with each other, suggesting that airway distensibility and volume recruitment were affected differently by airway smooth muscle tone. Assuming that Grs mainly reflects airway caliber and Xrs the number of ventilated lung units, we conclude that airway smooth muscle contributes to airway stiffness and ventilation inhomogeneities in COPD subjects with prevailing bronchitis but only to the latter in those with more emphysema. We suggest that changes of airway distensibility and volume recruitment with a bronchodilator may be useful for disease phenotyping.
Authors:
Simonetta Baldi; Raffaele Dellacà; Leonardo Govoni; Roberto Torchio; Andrea Aliverti; Pasquale Pompilio; Luciano Corda; Claudio Tantucci; Carlo Gulotta; Vito Brusasco; Riccardo Pellegrino
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Publication Detail:
Type:  Journal Article     Date:  2010-07-22
Journal Detail:
Title:  Journal of applied physiology (Bethesda, Md. : 1985)     Volume:  109     ISSN:  1522-1601     ISO Abbreviation:  J. Appl. Physiol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-13     Completed Date:  2011-05-23     Revised Date:  2013-09-26    
Medline Journal Info:
Nlm Unique ID:  8502536     Medline TA:  J Appl Physiol (1985)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1019-26     Citation Subset:  IM    
Affiliation:
Fisiopatologia Respiratoria, Centro Medico di Riabilitazione di Montescano, Fondazione Salvatore Maugeri IRCCS, Via per Montescano, 31, 27040 Montescano (Pavia), Italy. simonetta.baldi@fsm.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Bronchitis, Chronic / drug therapy,  etiology,  physiopathology*,  radiography
Bronchodilator Agents / therapeutic use
Case-Control Studies
Female
Forced Expiratory Volume
Functional Residual Capacity
Humans
Lung / drug effects,  physiopathology*,  radiography
Lung Compliance* / drug effects
Lung Volume Measurements
Male
Middle Aged
Oscillometry
Pressure
Pulmonary Disease, Chronic Obstructive / drug therapy,  etiology,  physiopathology*,  radiography
Pulmonary Emphysema / drug therapy,  etiology,  physiopathology*,  radiography
Respiratory Mechanics
Severity of Illness Index
Smoking / adverse effects
Smoking Cessation
Tomography, X-Ray Computed
Total Lung Capacity
Chemical
Reg. No./Substance:
0/Bronchodilator Agents

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