Estimating Airway Resistance from Forced Expiration in Spirometry
Spirometry is the gold standard to detect airflow limitation, but it does not measure airway resistance, which is one of the physiological factors behind airflow limitation. In this study, we describe the dynamics of forced expiration in spirometry using a deflating balloon and using this model. We...
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MDPI AG
2019-07-01
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| Series: | Applied Sciences |
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| Online Access: | https://www.mdpi.com/2076-3417/9/14/2842 |
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| author | Nilakash Das Kenneth Verstraete Marko Topalovic Jean-Marie Aerts Wim Janssens |
| author_facet | Nilakash Das Kenneth Verstraete Marko Topalovic Jean-Marie Aerts Wim Janssens |
| author_sort | Nilakash Das |
| collection | DOAJ |
| description | Spirometry is the gold standard to detect airflow limitation, but it does not measure airway resistance, which is one of the physiological factors behind airflow limitation. In this study, we describe the dynamics of forced expiration in spirometry using a deflating balloon and using this model. We propose a methodology to estimate ζ (zeta), a dimensionless and effort-independent parameter quantifying airway resistance. In N = 462 (65 ± 8 years), we showed that ζ is significantly (<i>p</i> < 0.0001) greater in COPD (2.59 ± 0.99) than healthy smokers (1.64 ± 0.18), it increased significantly (<i>p</i> < 0.0001) with the severity of airflow limitation and it correlated significantly (<i>p</i> < 0.0001) with airway resistance (r = 0.55) and specific conductance (r = −0.60) obtained from body-plethysmography. ζ also showed significant associations (<i>p</i> < 0.001) with diffusion capacity (r = −0.64), air-trapping (r = 0.68), and CT densitometry of emphysema (r = 0.40 against % below −950 HU and r = −0.34 against 15th percentile HU). Moreover, simulation studies demonstrated that an increase in ζ resulted in lower airflows from baseline. Therefore, we conclude that ζ quantifies airway resistance from forced expiration in spirometry—a method that is more abundantly available in primary care than traditional but expensive methods of measuring airway resistance such as body-plethysmography and forced oscillation technique. |
| first_indexed | 2024-12-13T00:53:10Z |
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| institution | Directory Open Access Journal |
| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-12-13T00:53:10Z |
| publishDate | 2019-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Applied Sciences |
| spelling | doaj.art-fad3f96311e34584a5e6049ce6d5fe9f2022-12-22T00:04:52ZengMDPI AGApplied Sciences2076-34172019-07-01914284210.3390/app9142842app9142842Estimating Airway Resistance from Forced Expiration in SpirometryNilakash Das0Kenneth Verstraete1Marko Topalovic2Jean-Marie Aerts3Wim Janssens4Laboratory for Respiratory Diseases, Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, 3000 Leuven, BelgiumLaboratory for Respiratory Diseases, Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, 3000 Leuven, BelgiumLaboratory for Respiratory Diseases, Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, 3000 Leuven, BelgiumMeasure, Model & Manage Bioresponses (M3-BIORES), Division Animal and Human Health Engineering, Department of Biosystems, KU Leuven, 3000 Leuven, BelgiumLaboratory for Respiratory Diseases, Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, 3000 Leuven, BelgiumSpirometry is the gold standard to detect airflow limitation, but it does not measure airway resistance, which is one of the physiological factors behind airflow limitation. In this study, we describe the dynamics of forced expiration in spirometry using a deflating balloon and using this model. We propose a methodology to estimate ζ (zeta), a dimensionless and effort-independent parameter quantifying airway resistance. In N = 462 (65 ± 8 years), we showed that ζ is significantly (<i>p</i> < 0.0001) greater in COPD (2.59 ± 0.99) than healthy smokers (1.64 ± 0.18), it increased significantly (<i>p</i> < 0.0001) with the severity of airflow limitation and it correlated significantly (<i>p</i> < 0.0001) with airway resistance (r = 0.55) and specific conductance (r = −0.60) obtained from body-plethysmography. ζ also showed significant associations (<i>p</i> < 0.001) with diffusion capacity (r = −0.64), air-trapping (r = 0.68), and CT densitometry of emphysema (r = 0.40 against % below −950 HU and r = −0.34 against 15th percentile HU). Moreover, simulation studies demonstrated that an increase in ζ resulted in lower airflows from baseline. Therefore, we conclude that ζ quantifies airway resistance from forced expiration in spirometry—a method that is more abundantly available in primary care than traditional but expensive methods of measuring airway resistance such as body-plethysmography and forced oscillation technique.https://www.mdpi.com/2076-3417/9/14/2842spirometryairflow limitationairway resistancespecific airway conductanceCOPDbody-plethysmographyforced expirationalveolar pressureemphysemacomputed tomographyair-trapping |
| spellingShingle | Nilakash Das Kenneth Verstraete Marko Topalovic Jean-Marie Aerts Wim Janssens Estimating Airway Resistance from Forced Expiration in Spirometry Applied Sciences spirometry airflow limitation airway resistance specific airway conductance COPD body-plethysmography forced expiration alveolar pressure emphysema computed tomography air-trapping |
| title | Estimating Airway Resistance from Forced Expiration in Spirometry |
| title_full | Estimating Airway Resistance from Forced Expiration in Spirometry |
| title_fullStr | Estimating Airway Resistance from Forced Expiration in Spirometry |
| title_full_unstemmed | Estimating Airway Resistance from Forced Expiration in Spirometry |
| title_short | Estimating Airway Resistance from Forced Expiration in Spirometry |
| title_sort | estimating airway resistance from forced expiration in spirometry |
| topic | spirometry airflow limitation airway resistance specific airway conductance COPD body-plethysmography forced expiration alveolar pressure emphysema computed tomography air-trapping |
| url | https://www.mdpi.com/2076-3417/9/14/2842 |
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