Effect of methacholine on peripheral lung mechanics and ventilation heterogeneity in asthma
Effect of methacholine on peripheral lung mechanics and ventilation heterogeneity in asthma
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DOI：
10.1152/japplphysiol.01198.2012
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发表时间：
2013-03-01
影响因子：
3.3
通讯作者：
King, Gregory G.
中科院分区：
文献类型：
--
作者：
Downie, Sue R.;Salome, Cheryl M.;King, Gregory G.
Downie SR, Salome CM, Verbanck S, Thompson BR, Berend N, King GG. Effect of methacholine on peripheral lung mechanics and ventilation heterogeneity in asthma. J Appl Physiol 114: 770-777, 2013. First published January 31, 2013; doi: 10.1152/japplphysiol.01198.2012.-The forced oscillation technique (FOT) and multiple-breath nitrogen washout (MBNW) are noninvasive tests that are potentially sensitive to peripheral airways, with MBNW indexes being especially sensitive to heterogeneous changes in ventilation. The objective was to study methacholine-induced changes in the lung periphery of asthmatic patients and determine how changes in FOT variables of respiratory system reactance (Xrs) and resistance (Rrs) and frequency dependence of resistance (Rrs(5)-Rrs(19)) can be linked to changes in ventilation heterogeneity. The contributions of air trapping and airway closure, as extreme forms of heterogeneity, were also investigated. Xrs(5), Rrs(5), Rrs(19), Rrs(5)-Rrs(19), and inspiratory capacity (IC) were calculated from the FOT. Ventilation heterogeneity in acinar and conducting airways, and trapped gas (percent volume of trapped gas at functional residual capacity/vital capacity), were calculated from the MBNW. Measurements were repeated following methacholine. Methacholine-induced airway closure (percent change in forced vital capacity) and hyperinflation (change in IC) were also recorded. In 40 mild to moderate asthmatic patients, increase in Xrs(5) after methacholine was predicted by increases in ventilation heterogeneity in acinar airways and forced vital capacity (r(2) = 0.37, P < 0.001), but had no correlation with ventilation heterogeneity in conducting airway increase or IC decrease. Increases in Rrs(5) and Rrs(5)-Rrs(19) after methacholine were not correlated with increases in ventilation heterogeneity, trapped gas, hyperinflation, or airway closure. Increased reactance in asthmatic patients after methacholine was indicative of heterogeneous changes in the lung periphery and airway closure. By contrast, increases in resistance and frequency dependence of resistance were not related to ventilation heterogeneity or airway closure and were more indicative of changes in central airway caliber than of heterogeneity.
