scholarly journals Airflow obstruction in sarcoidosis

2013 ◽  
Vol 66 (suppl. 1) ◽  
pp. 39-41
Author(s):  
Aleksandra Dudvarski-Ilic ◽  
Spasoje Popevic ◽  
Mihailo Stjepanovic ◽  
Branislav Gvozdenovic ◽  
Branislava Milenkovic ◽  
...  
Keyword(s):  
Pulmonary Fibrosis ◽  
Pulmonary Function ◽  
Airflow Obstruction ◽  
Lung Parenchyma ◽  
Forced Expiratory Volume ◽  
Airflow Limitation ◽  
Small Airways ◽  
Lung Capacity ◽  
Late Stages ◽  
Expiratory Flow Rates

Introduction. Aberrations in pulmonary function test are present in about 20% of patients with radiographic stage I sarcoidosis, whereas the pulmonary function is damaged in 40-80% of patients with parenchymal infiltrates (stages II, III or IV). Discussion and Review of Literature. Reductions in lung volumes (vital capacity and total lung capacity) are characteristic. The diffusing capacity of lungs is often reduced, but it is less pronounced in sarcoidosis than in idiopathic pulmonary fibrosis. Oxygenation is usually preserved until late in the course of sarcoidosis. Airflow obstruction (reduced forced expiratory volume in one second and expiratory flow rates) and bronchial hyper-reactivity occur in 30-50% of sarcoidosis patients with pulmonary parenchymal involvement. Conclusion. While restrictive spirometry pattern could easily be explained by fibrous changes in lung parenchyma, especially in late stages of the lung disease, pathogenesis of airflow limitation can be attributed mostly to endobronchial involvement (intraluminal granuloma or fibrous scars formation), airway compression due to enlarged lymph nodes and to distortion of small airways due to established pulmonary fibrosis.

scholarly journals Functional parameters of small airways can guide bronchodilator use in idiopathic pulmonary fibrosis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Po-Wei Hu ◽  
Hsin-Kuo Ko ◽  
Kang-Cheng Su ◽  
Jia-Yih Feng ◽  
Wei-Juin Su ◽  
...  
Keyword(s):  
Lung Function ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Airflow Limitation ◽  
Small Airways ◽  
Symptom Scores ◽  
Bronchodilator Treatment ◽  
Long Acting

Abstract Idiopathic pulmonary fibrosis (IPF) may present comorbid obstructive lung diseases with small airway dysfunction (SAD). Existing guidelines suggest that inhaled bronchodilators should be used if the ratio of forced expiratory volume in the 1st second and forced vital capacity (FEV1/FVC) < 0.7 in IPF. However, most IPF patients have FEV1/FVC > 0.7 even with coexisting emphysema. We retrospectively enrolled IPF patients who were registered at our outpatient clinic. At baseline, 63 patients completed computed tomography (CT) scans, lung function measurements, and symptom questionnaires. Among these patients, 54 (85.71%) underwent antifibrotic treatment and 38 (60.32%) underwent long-acting bronchodilator treatment. The median FEV1/FVC was 0.86. Not all patients treated with bronchodilators showed significant changes in lung function. IPF patients with SAD, determined by IOS parameters, showed significant improvement in FEV1, FEF25–75%, and symptom scores after bronchodilator treatment. Bronchodilator efficacy was not observed in patients without SAD. CT-confirmed emphysema was seen in 34.92% of patients. There were no changes in lung function or symptom scores after bronchodilator treatment in patients with emphysema. In conclusion, FEV1/FVC cannot reflect the airflow limitation in IPF. Emphysema in IPF is not a deciding factor in whether patients should receive bronchodilator treatment. IOS parameters may be useful to guide bronchodilator therapy in patients with IPF coexisting with SAD.

scholarly journals Longitudinal Assessment of Pulmonary Function and Bronchodilator Response in Pediatric Patients With Post-infectious Bronchiolitis Obliterans

2021 ◽  
Vol 9 ◽  
Author(s):  
Xiuhua Yu ◽  
Jiaoyang Wei ◽  
Yanchun Li ◽  
Lu Zhang ◽  
Hongming Che ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Bronchiolitis Obliterans ◽  
Pediatric Patients ◽  
Average Rate ◽  
Pulmonary Function Tests ◽  
Case Series ◽  
Lung Parenchyma ◽  
Forced Expiratory Volume ◽  
Longitudinal Assessment ◽  
Bronchodilator Response

Backgroud: Postinfectious bronchiolitis obliterans (PIBO) is a rare respiratory disease. In recent years, the disease has been recognized and diagnosed increasingly in children. Pulmonary function is important for diagnosis, identifying the severity of the PIBO and monitoring progression. But there have been only a few studies that followed the evolution of PIBO on the basis of pulmonary function tests (PFTs).Objective: The study targeted the evolution of pulmonary function and bronchodilator response in a case series of Chinese children with PIBO.Methods: Twelve children between the ages of 6–99 months with PIBO were studied retrospectively from 2009 to 2019. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), the FEV1/FVC ratio, and maximal midexpiratory flow velocity 25–75% (MMEF25−75%) were collected at each PFT, and bronchodilator responses were evaluated. Spirometric parameters were monitored over time, and generalized linear mixed models were used to analyze longitudinal panel data.Results: The median baseline PFT values for FVC, FEV1, the FEV1/FVC ratio, and MMEF25−75% were 41.6, 39.75, 90.7, and 22.2%, respectively. At the initial PFTs, 10 (83.3%) patients demonstrated a significant bronchodilator response. FVC and FEV1 increased by 8.212%/year and 5.007%/year, respectively, and the FEV1/FVC ratio decreased by an average of 3.537%/year. MMEF25−75% showed improvement at an average rate of 1.583% every year. Overall, FEV1 and MMEF25−75% showed different degrees of improvement after the use of inhaled bronchodilators at each PFT session for 10 patients, and FEV1 measures demonstrated significant (&gt;12%) β2-bronchodilation in 56% of PFT sessions.Conclusions: Pediatric patients with PIBO showed an obstructive defect in pulmonary function. The FVC, FEV1, and MMEF25−75% improved as they grew older, while the FEV1/FVC ratio decreased. This may be due to the development of lung parenchyma more than airway growth. Airway obstruction in some patients improved with the use of β2 agonists.

scholarly journals Comparision of the Spirometric Measurements of Multi-National Under-graduate Medical Students from a Medical College of Central Nepal

2019 ◽  
Vol 15 (2) ◽  
pp. 144-149
Author(s):  
Sameer Timilsina ◽  
Sirisa Karki ◽  
Bhuwan Baskota
Keyword(s):  
Medical Students ◽  
Pulmonary Function ◽  
Clinical Medicine ◽  
Airflow Obstruction ◽  
Preoperative Assessment ◽  
Prediction Equation ◽  
Airflow Limitation ◽  
Sri Lankan ◽  
Anthropometric Parameters ◽  
Significant Difference

Background: The application of pulmonary function testing is increasing in many areas of clinical medicine, including assessment of airflow limitation, diagnosis of airflow obstruction and lung restriction, evaluation of pulmonary impairment, preoperative assessment as well as public health screening. In this study, attempt has been made to evaluate Pulmonary Function Test (PFT) of healthy Nepalese young adults and compare their values with healthy Indian and Sri Lankan counterparts. Further, it tries to shed light on the correlation of these data with anthropometric parameters. Methods: A total of 133 pre-clinical medical students of Manipal College of Medical Sciences were included in the study. PFT was done using a computerized automatic spirometer. Results: All the pulmonary parameters showed significant gender differences. All mean value of PFT parameters were higher in males. The comparisons of different parameters of PFT according to gender between three countries namely Nepal, India and Sri Lanka showed that Nepalese and Indian females had a higher FEV1 and FVC values than Sri Lankan females (p<0.05). Sri Lankan females had lower FEV1 and FVC as compared to Nepalese and Indian females (p<0.05). However, no correlation was observed between PFTs and BMI. Conclusions: Although some significant differences on PFT parameters were observed in Sri Lankan data when compared with Nepalese and Indian data, no significant difference was noticed between Nepalese and Indian values of PFT. Therefore Indian prediction equation for PFT can be used for Nepal but only after further study with a larger sample size.

scholarly journals Maximal mid-expiratory flow detects early lung disease in α1-antitrypsin deficiency

2017 ◽  
Vol 49 (3) ◽  
pp. 1602055 ◽  
Author(s):  
James A. Stockley ◽  
Asem M. Ismail ◽  
Siân M. Hughes ◽  
Ross Edgar ◽  
Robert A. Stockley ◽  
...  
Keyword(s):  
Health Status ◽  
Lung Disease ◽  
Airflow Obstruction ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Small Airways ◽  
Antitrypsin Deficiency ◽  
Expiratory Flow ◽  
Group 2 ◽  
Group 1

Pathological studies suggest that loss of small airways precedes airflow obstruction and emphysema in chronic obstructive pulmonary disease (COPD). Not all α1-antitrypsin deficiency (AATD) patients develop COPD, and measures of small airways function might be able to detect those at risk.Maximal mid-expiratory flow (MMEF), forced expiratory volume in 1 s (FEV1), ratio of FEV1/forced vital capacity (FVC), health status, presence of emphysema (computed tomography (CT) densitometry) and subsequent decline in FEV1 were assessed in 196 AATD patients.FEV1/FVC, FEV1 % predicted and lung densitometry related to MMEF % pred (r2=0.778, p<0.0001; r2=0.787, p<0.0001; r2=0.594, p<0.0001, respectively) in a curvilinear fashion. Patients could be divided into those with normal FEV1/FVC and MMEF (group 1), normal FEV1/FVC and reduced MMEF (group 2) and those with spirometrically defined COPD (group 3). Patients in group 2 had worse health status than group 1 (median total St George's Respiratory Questionnaire (SGRQ) 23.15 (interquartile range (IQR) 7.09–39.63) versus 9.67 (IQR 1.83–22.35); p=0.006) and had a greater subsequent decline in FEV1 (median change in FEV1 −1.09% pred per year (IQR −1.91–0.04% pred per year) versus −0.04% pred per year (IQR −0.67–0.03% pred per year); p=0.007).A reduction in MMEF is an early feature of lung disease in AATD and is associated with impaired health status and a faster decline in FEV1.

scholarly journals Longitudinal Assessment of Pulmonary Function and Bronchodilator Responses in Pediatric Patients with Post-Infectious Bronchiolitis Obliterans

2021 ◽  
Author(s):  
Xiuhua Yu ◽  
Jiaoyang Wei ◽  
Yanchun Li ◽  
Lu Zhang ◽  
Hongming Che ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Bronchiolitis Obliterans ◽  
Pediatric Patients ◽  
Pulmonary Function Tests ◽  
Case Series ◽  
Lung Parenchyma ◽  
Forced Expiratory Volume ◽  
Longitudinal Assessment ◽  
Bronchodilator Response ◽  
Post Infectious

Abstract Objective: We aimed to further assess the evolution of pulmonary function and bronchodilator response in the Chinese case series with post-infectious bronchiolitis obliterans (PIBO). Methods: Twelve children with PIBO, aged 59-110 months, were retrospectively studied between 2011 and 2019. According to the ATS/ERS recommendations, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC and maximal midexpiratory flow velocity 25%-75% (MMEF25%-75%) were collected at each pulmonary function tests (PFTs), as well as bronchodilator responses were evaluated. Spirometric parameters were monitored over time, and generalized linear mixed models were used to analyze longitudinal panel data. Results: The median baseline PFT values for FVC, FEV1, FEV1/FVC ratio and MMEF25% -75% were 41.6%, 39.75%, 90.7% and 22.2% respectively. At the initial PFTs, 10 (83.3%) patients demonstrated a significant bronchodilator response. FVC and FEV1 increased by a mean of 8.212%/year and 5.007%/year, and FEV1/FVC ratio with an average decrease of 3.537%/year. MMEF25-75% showed an average increase of 1.583% per year. Over all, FEV1 and MMEF25%-75% showed different degrees of improvement after inhaled bronchodilators at each PFT sessions for ten patients, and FEV1 was with significant (>12%) β2-bronchodilation in 53% of PFT sessions. Conclusions: Pediatric patients with PIBO showed an obstructive defect of pulmonary function. The FVC, FEV1 and MMEF25%-75% improved as they grew old, while FEV1/FVC ratio decreased. It may be due to the development of lung parenchyma more than airway growth. Airway obstruction of some patients improved with the use of β2 agonists.

scholarly journals Somatotypes trajectories during adulthood and their association with COPD phenotypes

2020 ◽  
Vol 6 (3) ◽  
pp. 00122-2020
Author(s):  
Miguel J. Divo ◽  
Marta Marin Oto ◽  
Ciro Casanova Macario ◽  
Carlos Cabrera Lopez ◽  
Juan P. de-Torres ◽  
...  
Keyword(s):  
Early Adulthood ◽  
Airflow Obstruction ◽  
Forced Expiratory Volume ◽  
Multiple Organ ◽  
Airflow Limitation ◽  
Initial Increase ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Continuous Increase ◽  
Copd Patients

RationaleChronic obstructive pulmonary disease (COPD) comprises distinct phenotypes, all characterised by airflow limitation.ObjectivesWe hypothesised that somatotype changes – as a surrogate of adiposity – from early adulthood follow different trajectories to reach distinct phenotypes.MethodsUsing the validated Stunkard's Pictogram, 356 COPD patients chose the somatotype that best reflects their current body build and those at ages 18, 30, 40 and 50 years. An unbiased group-based trajectory modelling was used to determine somatotype trajectories. We then compared the current COPD-related clinical and phenotypic characteristics of subjects belonging to each trajectory.Measurements and main resultsAt 18 years of age, 88% of the participants described having a lean or medium somatotype (estimated body mass index (BMI) between 19 and 23 kg·m−2) while the other 12% a heavier somatotype (estimated BMI between 25 and 27 kg·m−2). From age 18 onwards, five distinct trajectories were observed. Four of them demonstrating a continuous increase in adiposity throughout adulthood with the exception of one, where the initial increase was followed by loss of adiposity after age 40. Patients with this trajectory were primarily females with low BMI and DLCO (diffusing capacity of the lung for carbon monoxide). A persistently lean trajectory was seen in 14% of the cohort. This group had significantly lower forced expiratory volume in 1 s (FEV1), DLCO, more emphysema and a worse BODE (BMI, airflow obstruction, dyspnoea and exercise capacity) score thus resembling the multiple organ loss of tissue (MOLT) phenotype.ConclusionsCOPD patients have distinct somatotype trajectories throughout adulthood. Those with the MOLT phenotype maintain a lean trajectory throughout life. Smoking subjects with this lean phenotype in early adulthood deserve particular attention as they seem to develop more severe COPD.

scholarly journals Pulmonary ventilation defects in older never-smokers

2014 ◽  
Vol 117 (3) ◽  
pp. 297-306 ◽  
Author(s):  
Khadija Sheikh ◽  
Gregory A. Paulin ◽  
Sarah Svenningsen ◽  
Miranda Kirby ◽  
Nigel A. M. Paterson ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Lung Disease ◽  
Obstructive Lung Disease ◽  
Pulmonary Function Tests ◽  
Pulmonary Ventilation ◽  
Forced Expiratory Volume ◽  
Airflow Limitation ◽  
Second Hand Smoke ◽  
Chronic Obstructive ◽  
Never Smokers

Hyperpolarized 3He MRI previously revealed spatially persistent ventilation defects in healthy, older compared with healthy, younger never-smokers. To understand better the physiological consequences and potential relevance of 3He MRI ventilation defects, we evaluated 3He-MRI ventilation-defect percent (VDP) and the effect of deep inspiration (DI) and salbutamol on VDP in older never-smokers. To identify the potential determinants of ventilation defects in these subjects, we evaluated dyspnea, pulmonary function, and cardiopulmonary exercise test (CPET) measurements, as well as occupational and second-hand smoke exposure. Fifty-two never-smokers (71 ± 6 yr) with no history of chronic respiratory disease were evaluated. During a single visit, pulmonary function tests, CPET, and 3He MRI were performed and the Burden of Obstructive Lung Disease questionnaire administered. For eight of 52 subjects, there was spirometry evidence of airflow limitation (Global Initiative for Chronic Obstructive Lung Disease-Unclassified, I, and II), and occupational exposure was reported in 13 of 52 subjects. In 13 of 52 (25%) subjects, there were no ventilation defects and in 39 of 52 (75%) subjects, ventilation defects were observed. For those subjects with ventilation defects, six of 39 showed a VDP response to DI/salbutamol. Ventilation heterogeneity and VDP were significantly greater, and forced expiratory volume in 1 s (FEV1)/forced vital capacity was significantly lower ( P < 0.05) for subjects with ventilation defects with a response to DI/salbutamol than subjects with ventilation defects without a response to DI/salbutamol and subjects without ventilation defects. In a step-wise, forward multivariate model, FEV1, inspiratory capacity, and airway resistance significantly predicted VDP ( R2 = 0.45, P < 0.001). In conclusion, most never-smokers had normal spirometry and peripheral ventilation defects not reversed by DI/salbutamol; such ventilation defects were likely related to irreversible airway narrowing/collapse but not to dyspnea and decreased exercise capacity.

scholarly journals Cytokine profile in the sputum of subjects with post-tuberculosis airflow obstruction and in those with tobacco related chronic obstructive pulmonary disease

2020 ◽  
Author(s):  
Elise Guiedem ◽  
Eric Walter Pefura-Yone ◽  
George Mondinde Ikomey ◽  
Céline Nkenfou ◽  
Martha Mesembe ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Airflow Obstruction ◽  
Forced Expiratory Volume ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
P Values ◽  
Copd Patients ◽  
History Of

Abstract Background: Previous studies have shown that tuberculosis (TB) is a risk factor for chronic airflow limitation. Chronic obstructive pulmonary disease (COPD) is recognized as the result of chronic inflammation, usually related to noxious particles. Post-TB airflow obstruction and tobacco-related COPD have the same functional pathway characterized by persistent airflow limitation. We sought to compare the profile of 29 cytokines in the sputum of subjects with post-TB airflow obstruction and those with COPD related to tobacco.Results: The forced expiratory volume in the first second (FEV1) and forced expiratory volume/forced vital capacity (FEV/FVC) ratio were lower in the COPD patients with the history of smoking compared to the post-TB airflow obstruction subgroup. The stages of the disease were more advanced in COPD / tobacco patients. Among the cytokines, IL-1α, IL-1β, MIP-1β, sCD40L and VEGF levels were higher in COPD patients, compared to the controls with p values ​​of 0.003, 0.0001, 0.03, 0.0001 and 0.02 respectively. When the two COPD subgroups were compared, IL-1α, IL-6, TNF-α and IL-8 levels were higher in the COPD patients with the history of tobacco compared to the COPD patients with the history of TB with p-values ​​of 0.031, 0.05, 0.021 and 0.016, respectively. Conclusion: COPD related to tobacco is more severe than post-TB airflow obstruction. The pathogenesis of post-TB airflow obstruction appears to involve the cytokines IL-1RA, IL-1α, IL-1β, IL-17, GRO and sCD40L, while COPD related to tobacco involves more cytokines.

scholarly journals Contribution of peripheral airway function to changes in FEV1/FVC and RV/TLC with aging

2018 ◽  
Vol 125 (5) ◽  
pp. 1378-1383 ◽  
Author(s):  
Christopher Htun ◽  
Alun Pope ◽  
Samir Lahzami ◽  
Darren Luo ◽  
Robin E. Schoeffel ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Vital Capacity ◽  
Total Lung Capacity ◽  
Forced Expiratory Volume ◽  
Residual Volume ◽  
Lung Capacity ◽  
Nitrogen Washout ◽  
Airway Function ◽  
Gas Trapping ◽  
Peripheral Airway

Multiple breath nitrogen washout (MBNW) indices provide insight into ventilation heterogeneity globally [lung clearance index (LCI)] and within acinar (Sacin) and conducting (Scond) airways. Normal aging leads to an accelerated deterioration of Sacin in older adults, but little is known about the contribution of peripheral airway function to changes in pulmonary function indices reflecting expiratory airflow [forced expiratory volume in one second (FEV1)/forced vital capacity (FVC)] and gas trapping [residual volume (RV)/total lung capacity (TLC)] with aging. We aimed to examine associations between MBNW and FEV1/FVC as well as RV/TLC in healthy adults, and to determine if these relationships differ in older (≥50 yr) versus younger subjects (<50 yr). Seventy-nine healthy adult volunteers aged 23–89 yr with no cardiac or respiratory disease and a smoking history of <5 pack-years underwent spirometry, plethysmography, and MBNW. After adjustment for sex, height, and body mass index, the following relationships were present across the entire cohort: Sacin was inversely related to FEV1/FVC (R2 = 0.22, P < 0.001); Sacin and Scond were positively related to RV/TLC (R2 = 0.53, P < 0.001); on separate analyses, the relationship between Sacin and FEV1/FVC was strongest in the older group (R2 = 0.20, P = 0.003) but markedly weaker in the younger group (R2 = 0.09, P = 0.04); and Sacin and Scond were related to RV/TLC in older (R2 = 0.20, P = 0.003) but not younger subgroups. No relationships were observed between LCI and FEV1/FVC or RV/TLC. Changes in FEV1/FVC and RV/TLC are at least in part due to changes in peripheral airway function with aging. Further studies of the relationships between MBNW and standard pulmonary function indices may prove useful for their combined application and interpretation in obstructive airways disease. NEW & NOTEWORTHY This study explores associations between multiple breath nitrogen washout (MBNW) and standard pulmonary function indices reflecting expiratory airflow [forced expiratory volume in one second (FEV1)/forced vital capacity (FVC)] and gas trapping [residual volume (RV)/total lung capacity (TLC)] in healthy adults across a wide range of ages. We have demonstrated statistically significant relationships between MBNW and FEV1/FVC as well as RV/TLC. These findings provide novel evidence of the contribution of peripheral airway function to changes in standard pulmonary function indices with aging.

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