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ERJ Open Research May 2023https://bit.ly/3AYRid6.
https://bit.ly/3AYRid6.
PubMed: 37377657
DOI: 10.1183/23120541.00070-2023 -
Indian Journal of Endocrinology and... 2023Obesity is known to induce lung function impairment. Previous studies of decline in lung function associated with obesity are well established.
BACKGROUND
Obesity is known to induce lung function impairment. Previous studies of decline in lung function associated with obesity are well established.
MATERIALS AND METHODS
In this cross-sectional study, to evaluate the effects of different obesity indices on lung mechanics, healthy subjects (males-23 and females-22) were recruited. Anthropometric parameters like body mass index (BMI), waist circumference (WC), hip circumference (HC) and neck circumference (NC) were measured and waist-hip ratio (WHR) was derived. Spirometry, impulse oscillometry (IOS) and fractional exhaled nitric oxide (FeNO) measurements were performed to assess lung function. Subgroups were divided and analysed.
RESULTS
In males, increased WHR is associated with increased total airway resistance (R). BMI correlates positively with R, R% predicted, resistance at 20 Hz (R) and R% predicted; likewise, WHR shows a positive correlation with R. In females, increased WHR has significantly higher R, R% predicted, R, R% predicted, area of reactance (Ax), resonant frequency (Fres) and decreased reactance at 5 Hz (X), reactance at 20 Hz (X), X% predicted. The female group with higher WC shows significantly increased R, R% predicted, R, R% predicted, Ax, Fres and lower fixed ratio of forced expiratory volume in 1 s (FEV)/forced vital capacity (FVC), X, X, X% predicted. The group with higher NC has a lower FEV/FVC ratio. WHR positively correlated with R% predicted and Fres while WC correlated positively with R, R% predicted, Ax and Fres; same way, NC with X% predicted.
CONCLUSION
Obesity/overweight causes significant changes in lung volumes, capacity and airway mechanics, Higher WC and WHR are associated with significant changes in lung mechanics, which are more prominent in females than in males. NC is not associated with changes in lung mechanics.
PubMed: 37292068
DOI: 10.4103/ijem.ijem_363_22 -
BMC Research Notes Jun 2023To investigated the dynamic ventilatory responses and their influence on functional exercise capacity in patients with long-COVID-19 syndrome (LCS).
OBJECTIVE
To investigated the dynamic ventilatory responses and their influence on functional exercise capacity in patients with long-COVID-19 syndrome (LCS).
RESULTS
Sixteen LCS patients were subjected to resting lung function (spirometry and respiratory oscillometry-RO) and cardiopulmonary performance to exercise (Spiropalm®-equipped six-minute walk test-6MWT and cardiopulmonary exercise test-CPX). At rest, spirometry showed a normal, restrictive and obstructive pattern in 87.5%, 6.25% and 6.25% of participants, respectively. At rest, RO showed increased resonance frequency, increased integrated low-frequency reactance and increased difference between resistance at 4-20 Hz (R4-R20) in 43.7%, 50%, and 31.2% of participants, respectively. The median of six-minute walking distance (DTC6) was 434 (386-478) m, which corresponds to a value of 83% (78-97%) of predicted. Dynamic hyperinflation (DH) and reduced breathing reserve (BR) were detected in 62.5% and 12.5% of participants, respectively. At CPX, the median peak oxygen uptake (VO) was 19 (14-37) ml/kg/min. There was a significant correlation of 6MWD with both R4-R20 (r=-0.499, P = 0.039) and VO (r=0.628, P = 0.009). Our results indicate that DH and low BR are contributors to poor exercise performance, which is associated with peripheral airway disease. These are promising results considering that they were achieved with simple, portable ventilatory and metabolic systems.
Topics: Humans; Walk Test; Post-Acute COVID-19 Syndrome; COVID-19; Lung; Walking; Exercise Test; Pulmonary Disease, Chronic Obstructive
PubMed: 37291610
DOI: 10.1186/s13104-023-06374-3 -
Anales de Pediatria Jun 2023To determine the performance of spirometry and respiratory oscillometry (RO) in the prediction of severe asthma exacerbations (SAEs) in children.
OBJECTIVE
To determine the performance of spirometry and respiratory oscillometry (RO) in the prediction of severe asthma exacerbations (SAEs) in children.
METHODS
In a prospective study, 148 children (age 6-14 years) with asthma were assessed with RO, spirometry and a bronchodilator (BD) test. Based on the findings of spirometry and the BD test, they were classified into three phenotypes: air trapping (AT), airflow limitation (AFL) and normal. Twelve weeks later, they were re-evaluated in relation to the occurrence of SAEs. We analysed the performance of RO, spirometry and AT/AFL phenotypes for prediction of SAEs by means of positive and negative likelihood ratios, ROC curves with the corresponding areas under the curve (AUCs) and a multivariate analysis adjusted for potential confounders.
RESULTS
During the follow-up, 7.4% of patients had SAEs, and there were differences between phenotypes (normal, 2.4%; AFL, 17.9%; AT, 22.2%, P = .005). The best AUC corresponded to the forced expiratory flow between 25% and 75% of vital capacity (FEF): 0.787; 95% confidence interval, 0.600-0.973. Other significant AUCs were those for the reactance area (AX), forced expiratory volume in the first second (FEV), the post-BD change in forced vital capacity (FVC), and the FEV/FVC ratio. All of the variables had a low sensitivity for prediction of SAEs. The AT phenotype had the best specificity (93.8%; 95% CI, 87.9-97.0), but the positive and negative likelihood ratios were both significant only for the FEF. In the multivariate analysis, only some spirometry parameters were significative for prediction of SAEs (AT phenotype, FEF and FEV/FVC).
CONCLUSIONS
Spirometry performed better than RO for prediction of SAEs in the medium term in schoolchildren with asthma.
Topics: Humans; Prospective Studies; Oscillometry; Asthma; Lung; Spirometry; Bronchodilator Agents
PubMed: 37246048
DOI: 10.1016/j.anpede.2023.05.003 -
Revista Da Associacao Medica Brasileira... 2023This study aimed to investigate if there is any correlation between the quantitative computed tomography and the impulse oscillometry or spirometry results of...
OBJECTIVE
This study aimed to investigate if there is any correlation between the quantitative computed tomography and the impulse oscillometry or spirometry results of post-COVID-19 patients.
METHODS
The study comprised 47 post-COVID-19 patients who had spirometry, impulse oscillometry, and high-resolution computed tomography examinations at the same time. The study group consisted of 33 patients with quantitative computed tomography involvement, while the control group included 14 patients who did not have CT findings. The quantitative computed tomography technology was used to calculate percentages of density range volumes. The relationship between percentages of density range volumes for different quantitative computed tomography density ranges and impulse oscillometry-spirometry findings was statistically analyzed.
RESULTS
In quantitative computed tomography, the percentage of relatively high-density lung parenchyma, including fibrotic areas, was 1.76±0.43 and 5.65±3.73 in the control and study groups, respectively. The percentages of primarily ground-glass parenchyma areas were found to be 7.60±2.86 and 29.25±16.50 in the control and study groups, respectively. In the correlation analysis, the forced vital capacity% predicted in the study group was correlated with DRV%[(-750)-(-500)] (volume of the lung parenchyma that has density between (-750)-(-500) Hounsfield units), but no correlation with DRV%[(-500)-0] was detected. Also, reactance area and resonant frequency were correlated with DRV%[(-750)-(-500)], while X5 was correlated with both DRV%[(-500)-0] and DRV%[(-750)-(-500)] density. Modified Medical Research Council score was correlated with predicted percentages of forced vital capacity and X5.
CONCLUSION
After COVID-19, forced vital capacity, reactance area, resonant frequency, and X5 correlated with the percentages of density range volumes of ground-glass opacity areas in the quantitative computed tomography. X5 was the only parameter correlated with density ranges consistent with both ground-glass opacity and fibrosis. Furthermore, the percentages of forced vital capacity and X5 were shown to be associated with the perception of dyspnea.
Topics: Humans; Oscillometry; COVID-19; Spirometry; Thorax; Tomography, X-Ray Computed
PubMed: 37222321
DOI: 10.1590/1806-9282.20221427 -
Annals of Allergy, Asthma & Immunology... Sep 2023In the year 2035, projections have estimated that 5% of the Scottish population will be morbidly obese defined as a body mass index (BMI) greater than or equal to 40...
BACKGROUND
In the year 2035, projections have estimated that 5% of the Scottish population will be morbidly obese defined as a body mass index (BMI) greater than or equal to 40 kg/m. Airway oscillometry is an effort-independent test akin to bronchial sonar which measures resistance and compliance.
OBJECTIVE
To evaluate the impact of obesity on lung mechanics using oscillometry.
METHODS
Clinical data for 188 patients with respiratory physician-diagnosed moderate-to-severe asthma were retrospectively collected and analyzed.
RESULTS
Obesity (BMI 30-39.9 kg/m) and morbid obesity (BMI ≥ 40 kg/m) were associated with a significantly worse heterogeneity of peripheral resistance between 5 Hz and 20 Hz and peripheral compliance as low-frequency reactance at 5 Hz and area under the reactance curve, as compared with normal weight (BMI 18.5-24.9 kg/m). Cluster analysis incorporating oscillometry identified a patient cohort who was older, obese, and female with combined impairment of spirometry and oscillometry coupled with more frequent severe exacerbations.
CONCLUSION
Obesity is associated with worse peripheral airway dysfunction in moderate-to-severe asthma, including a patient cluster who was older, obese, and female with more frequent exacerbations.
Topics: Humans; Adult; Female; Obesity, Morbid; Retrospective Studies; Oscillometry; Asthma; Lung; Spirometry
PubMed: 37209835
DOI: 10.1016/j.anai.2023.05.014 -
Environmental Pollution (Barking, Essex... Aug 2023Exposure to phthalates and synthetic phenols is ubiquitous. Some of them are suspected to impact child respiratory health, although evidence still remains insufficient....
Exposure to phthalates and synthetic phenols is ubiquitous. Some of them are suspected to impact child respiratory health, although evidence still remains insufficient. This study investigated the associations between prenatal exposure to phthalates and phenols, individually and as a mixture, and child respiratory health assessed by objective lung function measures since 2 months of age. Among 479 mother-child pairs from the SEPAGES cohort, 12 phenols, 13 phthalate and 2 non-phthalate plasticizer metabolites were measured in 2 pools including each 21 urine samples collected at the 2nd and 3rd pregnancy trimesters. Lung function was measured at 2 months using tidal breathing flow-volume loops and nitrogen multiple-breath washout, and at 3 years using oscillometry. Asthma, wheezing, bronchitis and bronchiolitis were assessed by repeated questionnaires. A cluster-based analysis was applied to identify exposure patterns to phenols and phthalates. Adjusted associations between clusters as well as each individual exposure biomarker and child respiratory health were estimated by regression models. We identified four prenatal exposure patterns: 1) low concentrations of all biomarkers (reference, n = 106), 2) low phenols-moderate phthalates (n = 162), 3) high concentrations of all biomarkers except bisphenol S (n = 109), 4) high parabens-moderate other phenols-low phthalates (n = 102). At 2 months, cluster 2 infants had lower functional residual capacity and tidal volume and higher ratio of time to peak tidal expiratory flow to expiratory time (t/t) and cluster 3 had lower lung clearance index and higher t/t. Clusters were not associated with respiratory health at 3 years but in the single-pollutant models, parabens were associated with increased area of the reactance curve, bronchitis (methyl, ethyl parabens) and bronchiolitis (propyl paraben). Our results suggested that prenatal exposure to mixtures of phthalates reduced lung volume in early life. Single exposure analyses suggested associations of parabens with impaired lung function and increased risk of respiratory diseases.
Topics: Pregnancy; Female; Infant; Humans; Parabens; Environmental Exposure; Prenatal Exposure Delayed Effects; Environmental Pollutants; Phenols; Phthalic Acids; Bronchitis; Biomarkers
PubMed: 37178953
DOI: 10.1016/j.envpol.2023.121794 -
Frontiers in Medicine 2023To use minimally-invasive transcatheter electrical impedance spectroscopy measurements for tissue differentiation among healthy lung tissue and pathologic lung tissue...
PURPOSE
To use minimally-invasive transcatheter electrical impedance spectroscopy measurements for tissue differentiation among healthy lung tissue and pathologic lung tissue from patients with different respiratory diseases (neoplasm, fibrosis, pneumonia and emphysema) to complement the diagnosis at real time during bronchoscopic procedures.
METHODS
Multi-frequency bioimpedance measurements were performed in 102 patients. The two most discriminative frequencies for impedance modulus (|Z|), phase angle (PA), resistance (R) and reactance (Xc) were selected based on the maximum mean pair-wise Euclidean distances between paired groups. One-way ANOVA for parametric variables and Kruskal-Wallis for non-parametric data tests have been performed with tests. Discriminant analysis has also been performed to find a linear combination of features to separate among tissue groups.
RESULTS
We found statistically significant differences for all the parameters between: neoplasm and pneumonia ( < 0.05); neoplasm and healthy lung tissue ( < 0.001); neoplasm and emphysema (p < 0.001); fibrosis and healthy lung tissue ( ≤ 0.001) and pneumonia and healthy lung tissue ( < 0.01). For fibrosis and emphysema ( < 0.05) only in |Z|, R and Xc; and between pneumonia and emphysema ( < 0.05) only in |Z| and R. No statistically significant differences ( > 0.05) are found between neoplasm and fibrosis; fibrosis and pneumonia; and between healthy lung tissue and emphysema.
CONCLUSION
The application of minimally-invasive electrical impedance spectroscopy measurements in lung tissue have proven to be useful for tissue differentiation between those pathologies that leads increased tissue and inflammatory cells and those ones that contain more air and destruction of alveolar septa, which could help clinicians to improve diagnosis.
PubMed: 37113605
DOI: 10.3389/fmed.2023.1108237 -
Therapeutic Advances in Respiratory... 2023A few studies have reported the medium-sized and small airway morphological abnormalities of bronchiolitis. Whether spirometry or impulse oscillometry (IOS) is...
BACKGROUND
A few studies have reported the medium-sized and small airway morphological abnormalities of bronchiolitis. Whether spirometry or impulse oscillometry (IOS) is correlated with airway remodeling of bronchiolitis remains unclear.
OBJECTIVES
Aiming to demonstrate the airway morphological abnormalities of bronchiolitis obliterans (BO) and diffuse panbronchiolitis (DPB) assessed by endobronchial optical coherence tomography (EB-OCT), and elucidate whether spirometric and IOS parameters have correlation with the airway remodeling of bronchiolitis.
METHODS
We recruited 18 patients with bronchiolitis (BO, = 9; DPB, = 9) and 17 control subjects. Assessments of clinical features, St. George's respiratory questionnaire (SGRQ), chest computed tomography (CT), spirometry, IOS, and EB-OCT were performed in all enrolled subjects. The correlation between EB-OCT and lung function parameters was studied and analyzed.
RESULTS
The magnitude of abnormalities of spirometric and IOS parameters was significantly greater in patients with bronchiolitis than that in control subjects ( < 0.05). Patients with BO had notably lower forced expiratory volume in 1 s (FEV), forced vital capacity (FVC), FEV/FVC, maximal mid-expiratory flow (MMEF)% pred and higher resonant frequency (Fres), and area of reactance (AX) than those with DPB ( < 0.05). The EB-OCT measurement among patients with bronchiolitis and between the bronchus in the left and the right lung demonstrated a heterogeneous distribution of airway calibers, presenting a high intra- and inter-individual variability. Patients with bronchiolitis had notably greater airway wall area ( < 0.05) compared with control, while BO presented greater magnitude of airway abnormalities than DPB. Fres and the difference in airway resistance at 5 and 20 Hz (R-R) correlated negatively with medium-sized and small airway inner area, and correlated positively with airway wall area ( < 0.05), whose correlation coefficients were higher than those of spirometric parameters.
CONCLUSION
Bronchiolitis, BO and DPB, manifested a heterogeneous distribution of airway calibers with significant intra- and inter-individual variability. IOS parameters, rather than spirometry, correlated better with medium-sized and small airway remodeling in bronchiolitis assessed by EB-OCT measurement.
Topics: Humans; Tomography, Optical Coherence; Airway Remodeling; Lung; Respiratory Function Tests; Spirometry; Forced Expiratory Volume; Bronchiolitis
PubMed: 37073792
DOI: 10.1177/17534666231167351 -
European Review For Medical and... Apr 2023Small airway dysfunction is a pathological component of chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF), and impulse oscillometry is...
OBJECTIVE
Small airway dysfunction is a pathological component of chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF), and impulse oscillometry is an easy-to-administer, effort-independent non-invasive test reflecting small airway dysfunction. We aimed to compare the impulse oscillometry (IOS) measurements between COPD and IPF patients and investigate their correlation with severity of both diseases and other conventional parameters.
PATIENTS AND METHODS
This was a prospective, longitudinal study. We longitudinally evaluated the baseline demographic characteristics, COPD Assessment Test (CAT) and modified Medical Research Council (mMRC) dyspnea scale, Pulmonary Function Test (PFT), Carbon Monoxide Diffusing Capacity (DLCO), Hemogram and Impulse Oscillometry measurements of the patients diagnosed with COPD and IPF.
RESULTS
The study included 60 IPF patients and 48 COPD patients. The CAT and mMRC scores were higher in COPD patients. The majority of COPD patients were classified into Category B (46%), while 68% of IPF patients had Stage 1 GAP. The mean FEF 25-75%, which is typically considered to reflect small airway disease, was 93% in IPF patients, while it was significantly lower in COPD patients (29%). Impulse oscillometry measurements were consistent with spirometry parameters. IOS resistance and reactance values were significantly higher in COPD patients than in IPF patients.
CONCLUSIONS
IOS is advantageous in COPD and IPF patients who cannot exhale due to severe dyspnea, as it is easy to administer and reflects small airway resistance better. Diagnosis of small airway dysfunction may be beneficial in the management of patients with IPF and COPD.
Topics: Humans; Oscillometry; Longitudinal Studies; Prospective Studies; Forced Expiratory Volume; Pulmonary Disease, Chronic Obstructive; Respiratory Function Tests; Lung; Spirometry; Idiopathic Pulmonary Fibrosis; Dyspnea
PubMed: 37070906
DOI: 10.26355/eurrev_202304_31937