Correlation among clinical, functional and morphological indexes of the respiratory system in non-cystic fibrosis bronchiectasis patients

Abstract

Background Non-cystic fibrosis bronchiectasis (NCFB) is a heterogeneous disease, which assessment and severity can’t be defined by one particular instrument but using a multidimensional score. Thus, in additional to traditional methods, alternative tools have been developed to assist these patients’ evaluation. Objective To correlate functional and morphological indexes with severity and dyspnea in NCFB patients, focusing on the correlation between the impulse oscillometry system (IOS) and the quantitative analysis of computed tomography (CT). Methods Clinically stable NCFB patients, between 18 and 80 years old were submitted to clinical, functional and morphological evaluations assessed by Bronchiectasis Severity Index (BSI) and Medical Research Council (MRC) scale; spirometry and IOS; and subjective and quantitative Chest CT scans analysis, respectively. Results This study included 38 patients. The best correlations obtained between functional and morphological airway indexes were: resistance at 5 Hz—R5 and the normalized thickness of bronchial walls—Pi10 (r = 0.57), and the mean forced expiratory flow (FEF25-75%) and CT score (r = -0.39). BSI as well as MRC showed higher correlations with the quantitative automated analysis of CT (BSI and Pi10: r = 0.41; MRC and Pi10: r = 0.35) than with subjective CT score (BSI and CT score: r = 0.41; MRC and CT score: r = 0.15); and moderate and weak correlations were obtained on both functional airway indexes (BSI and peripheral airways resistance - R5-R20: r = 0.53; BSI and forced expiratory volume at the first second—FEV1: R = -0,64; MRC and R5-R20: r = 0.42; and MRC and VEF1: r = -0.45). Conclusion In NCFB patients, compartmentalized methods for assessing the respiratory system (IOS and the automated quantitative CT analysis) have a good correlation with severity and dyspnea.

Airspace Diameter Map—A Quantitative Measurement of All Pulmonary Airspaces to Characterize Structural Lung Diseases

“…Since, in many lung diseases, the distribution of the damage is often heterogeneous, a stereological approach becomes much more time-consuming because the fraction of the lung that has to be analyzed increases dramatically up to the entire lung. For muco-obstructive lung diseases such as cystic fibrosis (CF) and COPD, as well as interstitial lung diseases such as pulmonary fibrosis, the recommended way to properly address the extent of the damage is by analy-zing the entire lung [21][22][23][24]. While many automated and semi-automated approaches for an analysis of the entire lung have been suggested in the recent decade [25,26], no complete analysis of lung airspace distribution of the total murine lung is available to date.…”