Heterogeneous airway tone in asthmatic subjects

1992 ◽  
Vol 73 (6) ◽  
pp. 2328-2332 ◽  
Author(s):  
G. Julia-Serda ◽  
N. A. Molfino ◽  
K. R. Chapman ◽  
P. A. McClean ◽  
N. Zamel ◽  
...  
Keyword(s):  
Lung Volume ◽  
Vital Capacity ◽  
Total Lung Capacity ◽  
Lung Parenchyma ◽  
Flow Volume ◽  
Lung Capacity ◽  
Group I ◽  
Expiratory Flow ◽  
Airway Tone ◽  
Volume History

We examined the effect of volume history on the dynamic relationship between airways and lung parenchyma (relative hysteresis) in 20 asthmatic subjects. The acoustic reflection technique was employed to evaluate changes in airway cross-sectional areas during a slow continuous expiration from total lung capacity to residual volume and inspiration back to total lung capacity. Lung volume was measured continuously during this quasi-static maneuver. We studied three anatomic airway segments: extra- and intrathoracic tracheal and main bronchial segments. Plots of airway area vs. lung volume were obtained for each segment to assess the relative magnitude and direction of the airway and parenchymal hysteresis. We also performed maximal expiratory flow-volume and partial expiratory flow-volume curves and calculated the ratio of maximal to partial flow rates (M/P) at 30% of the vital capacity. We found that 10 subjects (group I) showed a significant predominance of airway over parenchymal hysteresis (P < 0.005) at the extra- and intrathoracic tracheal and main bronchial segments; these subjects had high M/P ratios [1.53 +/- 0.27 (SD)]. The other 10 subjects (group II) showed similar airway and parenchymal hysteresis for all three segments and significantly lower M/P ratios (1.16 +/- 0.20, P < 0.01). We conclude that the effect of volume history on the relative hysteresis of airway and lung parenchyma and M/P ratio at 30% of vital capacity in nonprovoked asthmatic subjects is variable. We suggest that our findings may result from heterogeneous airway tone in asthmatic subjects.

Effect of volume history on distribution of inspired gas in asthmatics

1987 ◽  
Vol 62 (3) ◽  
pp. 1179-1185 ◽  
Author(s):  
R. B. Filuk ◽  
N. R. Anthonisen
Keyword(s):  
Vital Capacity ◽  
Total Lung Capacity ◽  
Lung Parenchyma ◽  
Phase Iii ◽  
Ventilation Distribution ◽  
Lung Capacity ◽  
Beta Agonists ◽  
Airway Tone ◽  
Washout Curves ◽  
Volume History

Twelve stable adult asthmatics slowly inhaled boluses of He at 20, 40, or 60% vital capacity (VC); these volumes were achieved either by expiring from total lung capacity (TLC) or by inspiring from residual volume (RV). Inspirations were continued to TLC and then were followed by slow expirations to RV while expired He was measured as a function of expired volume. At 20% VC slopes of alveolar plateaus (phase III) were positive, at 40% VC they were flat, and at 60% VC they were negative; at 20 and 60% VC the slopes were steeper than those in normals. When boluses were administered at 40 and 60% VC, He washout curves were independent of lung volume history. However at 20% VC the slope of phase III was significantly less positive when boluses were given after inspiration from RV than after expiration from TLC. In eight subjects, who were given inhaled beta-agonists, slopes of all He washouts decreased and became independent of volume history at 20% VC. We conclude that in asthmatics at low lung volumes the airways that determine ventilation distribution behave as though they have less hysteresis than the lung parenchyma probably due to increased airway tone.

Increased gravitational stress does not alter maximum expiratory flow

1985 ◽  
Vol 59 (1) ◽  
pp. 28-33 ◽  
Author(s):  
D. Pyszczynski ◽  
S. N. Mink ◽  
N. R. Anthonisen
Keyword(s):  
Vital Capacity ◽  
Total Lung Capacity ◽  
Maximum Flow ◽  
Flow Volume ◽  
Lung Capacity ◽  
Gravitational Stress ◽  
Regional Lung ◽  
Maximum Expiratory Flow ◽  
Expiratory Flow ◽  
Capacity Data

We measured maximum expiratory flow-volume (MEFV) curves in six seated subjects during normal (+1 Gz) and increased (+2 and +3 Gz) gravitational stress. Full MEFV curves, initiated at total lung capacity, were recorded, as were partial MEFV curves, initiated at approximately 60% of the vital capacity. Data were acquired in all subjects breathing air at +1 and +2 Gz; results were available for three subjects breathing 80% He-20% O2 at +1 and +2 Gz, and in two subjects, results were obtained at +3 Gz. Changes in gravitational stress were not associated with changes of either full or partial MEFV curves. The known increase in differences of regional lung volume and recoil caused by increased gravitational stress did not influence maximum expiratory flow. Though increased gravitational stress probably changed regional emptying sequences little during full MEFV maneuvers, substantial changes of emptying sequence were expected during partial maneuvers. It is possible that such changes in emptying sequence occurred but were not associated with changes in maximum flow because the latter was determined by choking in central airways common to all regions.

Changes in regional emptying sequence need not change maximum expiratory flow

1986 ◽  
Vol 60 (6) ◽  
pp. 1834-1838 ◽  
Author(s):  
R. B. Filuk ◽  
N. R. Anthonisen
Keyword(s):  
Vital Capacity ◽  
Total Lung Capacity ◽  
Young Men ◽  
Forced Expiration ◽  
Flow Volume ◽  
Lung Volumes ◽  
Lung Capacity ◽  
Maximum Expiratory Flow ◽  
Expiratory Flow

Nine normal young men inhaled boluses of He at the onset of slow vital capacity (VC) inspirations. During the subsequent VC expirations, we measured expired flow, volume, and He concentrations. Expirations consisted of full or partial maximum expiratory flow-volume (MEFV) maneuvers. Full maneuvers were forced expirations from total lung capacity (TLC). Partial maneuvers were accomplished by expiring slowly from TLC to 70, 60, 50, and 40% VC and then initiating forced expiration. Expired He concentrations from full and partial maneuvers were compared with each other and with those resulting from slow expirations. At comparable volumes less than 50% VC, flow during partial and full MEFV maneuvers did not differ. Expired He concentrations were higher during partial maneuvers than during full ones; at the onset of partial maneuvers upper zone emptying predominated, whereas this was not the case at the same lung volumes during maneuvers initiated at TLC. We observed substantial differences in regional emptying sequence that did not influence maximum expiratory flow.

Influence of Breath Holding at Total Lung Capacity on Maximal Expiratory Flow Measurements

1981 ◽  
Vol 60 (1) ◽  
pp. 11-15 ◽  
Author(s):  
T. Higenbottam ◽  
T. J. H. Clark
Keyword(s):  
Vital Capacity ◽  
Total Lung Capacity ◽  
Breath Hold ◽  
Flow Volume ◽  
Flow Measurements ◽  
Lung Capacity ◽  
Maximal Expiratory Flow ◽  
Volume Curve ◽  
Flow Volume Curve ◽  
Expiratory Flow

1. Forced exhalations performed from volumes below total lung capacity, so-called partial expiratory flow-volume curves, are suggested to be more sensitive in detecting airways bronchoconstriction than maximal expiratory flow-volume curves begun at total lung capacity. 2. In eight healthy men both maximal and partial expiratory flow-volume curves were measured where breath was held at total lung capacity or 70% of vital capacity respectively, for either 0 or 15 s before performing the forced exhalation. An histamine aerosol was used to provoke bronchoconstriction. 3. The results showed that the 15 s breath hold caused greater reduction in expiratory flow rates after histamine for both maximal and partial expiratory flow-volume curves than either manoeuvres performed with no breath hold. 4. A breath hold of 15 s at total lung capacity appeared to make the maximal expiratory flow-volume curve as sensitive as a partial expiratory flow-volume curve in detecting the response to histamine as well as providing measurements of forced expiratory volume in 1 s and vital capacity. Forced spirometry after a 15 s breath hold at total lung capacity therefore provides an easy and sensitive technique for detecting bronchoconstriction.

Pattern and mechanism of airway response to hypocapnia in normal subjects

1979 ◽  
Vol 47 (1) ◽  
pp. 8-12 ◽  
Author(s):  
C. F. O'Cain ◽  
M. J. Hensley ◽  
E. R. McFadden ◽  
R. H. Ingram
Keyword(s):  
Vital Capacity ◽  
Normal Subjects ◽  
Oxygen Mixture ◽  
Flow Volume ◽  
Mixture Density ◽  
Lung Capacity ◽  
Airway Constriction ◽  
Maximal Expiratory Flow ◽  
Airway Response ◽  
Expiratory Flow

We examined the bronchoconstriction produced by airway hypocapnia in normal subjects. Maximal expiratory flow at 25% vital capacity on partial expiratory flow-volume (PEFV) curves fell during hypocapnia both on air and on an 80% helium- 20% oxygen mixture. Density dependence also fell, suggesting predominantly small airway constriction. The changes seen on PEFV curves were not found on maximal expiratory flow-volume curves, indicating the inhalation to total lung capacity substantially reversed the constriction. Pretreatment with a beta-sympathomimetic agent blocked the response, whereas atropine pretreatment did not, suggesting that hypocapnia affects airway smooth muscle directly, not via cholinergic efferents.

Airway responses to inhaled histamine in asymptomatic smokers and nonsmokers

1977 ◽  
Vol 42 (4) ◽  
pp. 508-513 ◽  
Author(s):  
N. E. Brown ◽  
E. R. McFadden ◽  
R. H. Ingram
Keyword(s):  
Vital Capacity ◽  
Total Lung Capacity ◽  
Aerosol Deposition ◽  
Flow Volume ◽  
Maximal Flow ◽  
Airway Reactivity ◽  
Lung Capacity ◽  
Large Airway ◽  
Airway Response ◽  
Airway Responses

Bronchia reactivity to inhaled histamine was assessed in asymptomatic cigarette smokers and in nonsmoking atopic and nonatopic subjects. The only prechallenge between-group difference was the ratio of maximal flow on 80% helium-20% oxygen (Vmax HeO2) to maximal flow on air (Vmax air) from partial expiratory flow volume curves at 25% vital capacity (25% VC PEFV): Mean +/- SEM for smokers 1.18 /+- 0.06, atopics 1.45 +/- 0.08, nonatopics 1.51 +/- 0.03. This suggests that prior to inhalation to total lung capacity, the predominant site of resistance at flow limitation was in smaller airways of the smokers and in larger airways of both groups of nonsmokers. Following inhalation of histamine, smokers and nonatopics had similar changes in lung volumes and Vmax air which were less than in atopics. The Vmax HeO2/Vmax air ratios at 25% VC PEFV increased in smokers and decreased in nonsmokers: smokers 1.48 +/- 0.08, atopics 1.22 +/- 0.10, nontopics 1.16 +/- 0.06. This suggests a predominant large airway response in smokers and a prominent small airway response in nonsmokers. These responses may reflect differences in the predominant site of aerosol deposition rather than in airway reactivity.

Lung volumes and expiratory flow limitation during exercise in interstitial lung disease

1994 ◽  
Vol 77 (2) ◽  
pp. 963-973 ◽  
Author(s):  
D. D. Marciniuk ◽  
G. Sridhar ◽  
R. E. Clemens ◽  
T. A. Zintel ◽  
C. G. Gallagher
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Lung Volume ◽  
Total Lung Capacity ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Lung Volumes ◽  
Lung Capacity ◽  
Ventilatory Capacity ◽  
Expiratory Flow

Lung volumes were measured at rest and during exercise by an open-circuit N2-washout technique in patients with interstitial lung disease (ILD). Exercise tidal flow-volume (F-V) curves were also compared with maximal F-V curves to investigate whether these patients demonstrated flow limitation. Seven patients underwent 4 min of constant work rate bicycle ergometer exercise at 40, 70, and 90% of their previously determined maximal work rates. End-expiratory lung volume and total lung capacity were measured at rest and near the end of each period of exercise. There was no significant change in end-expiratory lung volume or total lung capacity when resting measurements were compared with measurements at 40, 70, and 90% work rates. During exercise, expiratory flow limitation was evident in four patients who reported stopping exercise because of dyspnea. In the remaining patients who discontinued exercise because of leg fatigue, no flow limitation was evident. In all patients, the mean ratio of maximal minute ventilation to maximal ventilatory capacity (calculated from maximal F-V curves) was 67%. We conclude that lung volumes during exercise do not significantly differ from those at rest in this population and that patients with ILD may demonstrate expiratory flow limitation during exercise. Furthermore, because most patients with ILD are not breathing near their maximal ventilatory capacity at the end of exercise, we suggest that respiratory mechanics are not the primary cause of their exercise limitation.

Effects of aerosol methacholine and histamine on airways and lung parenchyma in healthy humans

1993 ◽  
Vol 74 (6) ◽  
pp. 2681-2686 ◽  
Author(s):  
R. Pellegrino ◽  
B. Violante ◽  
E. Crimi ◽  
V. Brusasco
Keyword(s):  
Vital Capacity ◽  
Transpulmonary Pressure ◽  
Lung Parenchyma ◽  
Forced Expiratory Volume ◽  
Flow Volume ◽  
Tissue Properties ◽  
Bronchodilator Effect ◽  
Healthy Humans ◽  
Forced Expiratory Flow ◽  
Expiratory Flow

To investigate whether histamine (His) and methacholine (MCh) have different effects on airways and lung parenchyma, 11 healthy subjects were given aerosol MCh until a response plateau was obtained and then two doses of His. At the plateau, forced expiratory volume in 1 s and forced expiratory flow at 40% of vital capacity from partial flow-volume curves were reduced by 19 +/- 3 (SE) and 80 +/- 4%, respectively. Aerosol His decreased forced expiratory volume in 1 s by an additional 12 +/- 1% but left partial forced expiratory flow unchanged. The bronchodilator effect of deep inhalation, as inferred from the ratio of forced expiratory flow from maximal to that from partial flow-volume curves, increased after MCh and plateaued but decreased after His. Quasi-static transpulmonary pressure-volume area determined in seven subjects was unchanged after MCh but was increased by 57 +/- 10% after His. We conclude that adding His after the response to MCh plateaued does not increase the maximal degree of bronchoconstriction but may increase parenchymal hysteresis, thus blunting the bronchodilator effect of deep inhalation. These results suggest that His and MCh have similar effects on airway smooth muscle but different effects on lung tissue properties.

Airway distensibility in healthy and asthmatic subjects: effect of lung volume history

2000 ◽  
Vol 88 (4) ◽  
pp. 1413-1420 ◽  
Author(s):  
David Peter Johns ◽  
John Wilson ◽  
Richard Harding ◽  
E. Haydn Walters
Keyword(s):  
Lung Volume ◽  
Total Lung Capacity ◽  
Normal Subjects ◽  
Residual Volume ◽  
Tidal Breathing ◽  
Lung Capacity ◽  
Mild Asthmatic ◽  
The Relationship ◽  
Asthmatic Group ◽  
Volume History

Anatomic dead space (Vd) is known to increase with end-inspiratory lung volume (EILV), and the gradient of the relationship has been proposed as an index of airway distensibility (ΔVd). The aims of this study were to apply a rapid method for measuring ΔVd and to determine whether it was affected by lung volume history. Vd of 16 healthy and 16 mildly asthmatic subjects was measured at a number of known EILVs by using a tidal breathing, CO2-washout method. The effect of lung volume history was assessed by using three tidal breathing regimens: 1) three discrete EILVs (low/medium/high; LMH); 2) progressively decreasing EILVs from total lung capacity (TLC; TLC-RV); and 3) progressively increasing EILVs from residual volume (RV; RV-TLC). ΔVd was lower in the asthmatic group for the LMH (25.3 ± 2.24 vs. 21.2 ± 1.66 ml/l, means ± SE) and TLC-RV (24.3 ± 1.69 vs. 18.7 ± 1.16 ml/l) regimens. There was a trend for a lower ΔVd in the asthmatic group for the RV-TLC regimen (23.3 ± 2.19 vs. 18.8 ± 1.68 ml/l). There was no difference in ΔVd between groups. In conclusion, mild asthmatic subjects have stiffer airways than normal subjects, and this is not obviously affected by lung volume history.

Flow-volume curves of excised right and left rabbit lungs

1979 ◽  
Vol 46 (3) ◽  
pp. 463-466 ◽  
Author(s):  
E. Yokoyama
Keyword(s):  
Unit Volume ◽  
Vital Capacity ◽  
Static Pressure ◽  
Total Lung Capacity ◽  
Peak Flow ◽  
Flow Volume ◽  
Lung Weight ◽  
Lung Capacity

Static pressure-volume (PV) curves and flow-volume (VV) curves of excised right and left rabbit lungs obtained by forced and passive deflation were compared. Deflation PV curves in which the volume was expressed as either ml/lung weight or percent total lung capacity were nearly identical between right and left lungs. Descending limbs of the forced VV curves in which the flow divided by vital capacity (VC) was plotted against %VC generally agreed between right and left lungs, although peak flow tended to be higher in left lungs. However, the flow obtained during passive deflation was higher in left lungs over most of the deflation suggesting that the resistance of proximal airways per unit volume is lower in left than in right lungs.

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