Assessment of proximal and peripheral airway dysfunction by computed tomography and respiratory impedance in asthma and COPD patients with fixed airflow obstruction
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 im...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2018-01-01
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| Series: | Annals of Thoracic Medicine |
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| Online Access: | http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2018;volume=13;issue=4;spage=212;epage=219;aulast=Pornsuriyasak |
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| author | Prapaporn Pornsuriyasak Thitiporn Suwatanapongched Wasana Thaipisuttikul Chayanin Nitiwarangkul Theerasuk Kawamatawong Naparat Amornputtisathaporn Kittipong Maneechotesuwan |
| author_facet | Prapaporn Pornsuriyasak Thitiporn Suwatanapongched Wasana Thaipisuttikul Chayanin Nitiwarangkul Theerasuk Kawamatawong Naparat Amornputtisathaporn Kittipong Maneechotesuwan |
| author_sort | Prapaporn Pornsuriyasak |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-12T21:39:44Z |
| format | Article |
| id | doaj.art-cc70eb4acb6a4f29b4240349acdabd1c |
| institution | Directory Open Access Journal |
| issn | 1817-1737 1998-3557 |
| language | English |
| last_indexed | 2024-12-12T21:39:44Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Thoracic Medicine |
| spelling | doaj.art-cc70eb4acb6a4f29b4240349acdabd1c2022-12-22T00:11:05ZengWolters Kluwer Medknow PublicationsAnnals of Thoracic Medicine1817-17371998-35572018-01-0113421221910.4103/atm.ATM_22_18Assessment of proximal and peripheral airway dysfunction by computed tomography and respiratory impedance in asthma and COPD patients with fixed airflow obstructionPrapaporn PornsuriyasakThitiporn SuwatanapongchedWasana ThaipisuttikulChayanin NitiwarangkulTheerasuk KawamatawongNaparat AmornputtisathapornKittipong ManeechotesuwanOBJECTIVE: 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.http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2018;volume=13;issue=4;spage=212;epage=219;aulast=PornsuriyasakAirway wall thicknessairway lumen areaexpiratory air trappingimpulse oscillometryrespiratory impedance |
| spellingShingle | Prapaporn Pornsuriyasak Thitiporn Suwatanapongched Wasana Thaipisuttikul Chayanin Nitiwarangkul Theerasuk Kawamatawong Naparat Amornputtisathaporn Kittipong Maneechotesuwan Assessment of proximal and peripheral airway dysfunction by computed tomography and respiratory impedance in asthma and COPD patients with fixed airflow obstruction Annals of Thoracic Medicine Airway wall thickness airway lumen area expiratory air trapping impulse oscillometry respiratory impedance |
| title | Assessment of proximal and peripheral airway dysfunction by computed tomography and respiratory impedance in asthma and COPD patients with fixed airflow obstruction |
| title_full | Assessment of proximal and peripheral airway dysfunction by computed tomography and respiratory impedance in asthma and COPD patients with fixed airflow obstruction |
| title_fullStr | Assessment of proximal and peripheral airway dysfunction by computed tomography and respiratory impedance in asthma and COPD patients with fixed airflow obstruction |
| title_full_unstemmed | Assessment of proximal and peripheral airway dysfunction by computed tomography and respiratory impedance in asthma and COPD patients with fixed airflow obstruction |
| title_short | Assessment of proximal and peripheral airway dysfunction by computed tomography and respiratory impedance in asthma and COPD patients with fixed airflow obstruction |
| title_sort | assessment of proximal and peripheral airway dysfunction by computed tomography and respiratory impedance in asthma and copd patients with fixed airflow obstruction |
| topic | Airway wall thickness airway lumen area expiratory air trapping impulse oscillometry respiratory impedance |
| url | http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2018;volume=13;issue=4;spage=212;epage=219;aulast=Pornsuriyasak |
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