Effects of exercise and β<sub>2</sub>-agonists on lung function  in chronic obstructive pulmonary disease

Corsico, Angelo Guido; Fulgoni, Paola; Beccaria, Massimiliano; Zoia, M. C.; Barisione, Giovanni; Pellegrino, Riccardo; Brusasco, Vito; Cerveri, Isa

doi:10.1152/japplphysiol.00490.2002

Cited by 9 publications

(4 citation statements)

References 34 publications

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“…Second, in asthmatic subjects, the effects of deep inhalation on airway caliber are in the same direction when assessed by forced expiratory flows or airway conductance (30,32), which is minimally or not at all affected by gas compression. Third, in subjects with established COPD, no correlation was found between maximal-topartial flow ratio and the common indexes of lung hyperinflation, namely, functional residual capacity and TLC as percent of predicted (5).…”

Section: Comments On Methodologymentioning

confidence: 90%

Small airway morphology and lung function in the transition from normality to chronic airway obstruction

Corsico¹,

Milanese²,

Baraldo³

et al. 2003

Journal of Applied Physiology

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This study investigated the relationships between pathological changes in small airways (<6 mm perimeter) and lung function in 22 nonasthmatic subjects (20 smokers) undergoing lung resection for peripheral lesions. Preoperative pulmonary function tests revealed airway obstruction [ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC) < 70%] in 12 subjects and normal lung function in 10. When all subjects were considered together, total airway wall thickness was significantly correlated with FEV1/FVC (r2 = 0.25), reactivity to methacholine (r2 = 0.26), and slope of linear regression of FVC against FEV1 values recorded during the methacholine challenge (r2 = 0.56). Loss of peribronchiolar alveolar attachments was significantly associated (r2 = 0.25) with a bronchoconstrictor effect of deep inhalation, as assessed from a maximal-to-partial expiratory flow ratio <1, but not with airway responses to methacholine. No significant correlation was found between airway smooth muscle thickness and lung function measurements. In conclusion, this study suggests that thickening of the airway wall is a major mechanism for airway closure, whereas loss of airway-to-lung interdependence may contribute to the bronchoconstrictor effect of deep inhalation in the transition from normal lung function to airway obstruction in nonasthmatic smokers.

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Section: Comments On Methodologymentioning

confidence: 90%

Small airway morphology and lung function in the transition from normality to chronic airway obstruction

Corsico¹,

Milanese²,

Baraldo³

et al. 2003

Journal of Applied Physiology

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“…The latter was slightly modified to examine the response of the airways to DI, as repeatedly reported in bronchial asthma [31,32] and COPD [22,23,33]. We also included the SBN 2 W-O by virtue of its high sensitivity to detect inhomogeneous distribution of ventilation [34].…”

Section: Discussionmentioning

confidence: 99%

How to interpret reduced forced expiratory volume in 1 s (FEV1)/vital capacity ratio with normal FEV1

Barisione

Crimi

Bartolini

et al. 2009

European Respiratory Journal

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The aim of the present study was to determine whether the combination of low forced expiratory volume in 1 s (FEV1)/vital capacity (VC) ratio with normal FEV1 represents a physiological variant or a sign of early airflow obstruction.We studied 40 subjects presenting with low FEV1/VC, but FEV1 within the range of normality predicted by European Respiratory Society reference equations, and 10 healthy controls. All subjects completed two questionnaires and underwent comprehensive pulmonary function testing, which included methacholine challenge and single-breath nitrogen wash-out.According to the questionnaires, the subjects were assigned to three groups, i.e. rhinitis (n58), bronchial asthma (n513) and chronic obstructive pulmonary disease (COPD; n512). Subjects with negative responses to questionnaires were assigned to an asymptomatic group (n57). Airway hyperresponsiveness was found in four subjects of the rhinitis group, all of the asthma group, and 10 of the COPD group; in the last two groups, it was associated with signs of increased airway closure and gas trapping. Bronchodilator response to salbutamol was positive in only a few individuals across groups. In the asymptomatic group, no significant functional changes were observed, possibly suggesting dysanaptic lung growth.In subjects with low FEV1/VC and normal FEV1, questionnaires on respiratory symptoms together with additional pulmonary function tests may help to clarify the nature of this pattern of lung function. KEYWORDS: Atopic rhinitis, bronchial asthma, chronic obstructive pulmonary disease, dysanaptic lung growth, methacholine challenge, single-breath nitrogen wash-out T he assumption that a decrease in forced expiratory volume in 1 s (FEV1) and its ratio to vital capacity (VC) below the fifth percentile of the predicted normal value indicates an obstructive pulmonary abnormality is a useful simple approach [1]. However, in some individuals with VC normal or higher than normal, the FEV1/VC ratio may lie below the normal range while the FEV1 is still above the lower limit of normality [2][3][4][5]. Whether this spirometric pattern represents a physiological variant, possibly due to dysanaptic lung growth [6][7][8], or an early sign of airflow obstruction, possibly due to increased airway resistance [9] or loss of elastic recoil [10], is unknown. As the treatment of obstructive pulmonary diseases is based on proper recognition of airflow obstruction [11,12], the interpretation of this functional pattern is of practical relevance.The present study was designed to investigate whether a careful assessment of respiratory symptoms, combined with tests sensitive to abnormalities of airway function, may help to interpret the pattern of low FEV1/VC ratio with normal FEV1. For this purpose, 40 subjects were studied who presented with an FEV1/VC ratio below and an FEV1 above their lower limits of normality according to the European Respiratory Society (ERS) predicting equations [13]. Symptoms were assessed by questionnaires and lung function by addit...

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“…25 Several hypotheses could be put forward to explain why the improvement in DH may not be readily translated into an increased exercise tolerance in advanced COPD: (i) exercise capacity may have been limited (or constrained) by other mechanisms, including peripheral factors (see above) and/or haemodynamics; (ii) the extent of DH amelioration may have not been sufficient to impact upon exercise tolerance in some hyperinflated patients with functionally weak respiratory muscles; 47 (iii) the negative effect of volume history on airway calibre due to deep inhalations during exercise (i.e. IC manoeuvres) may have offset pharmacologically induced bronchodilation; 48 (iv) as the relationship between dyspnoea and DH is not linear, 13 these patients may need a relatively large improvement in DH for a measurable decrease in exercise breathlessness; and, importantly, (v) severely impaired patients with chronic dyspnoea may not be as motivated as less disabled patients to exercise to the point of limiting breathlessness-even after active bronchodilation.…”

Section: Article In Pressmentioning

confidence: 99%

Effects of formoterol on exercise tolerance in severely disabled patients with COPD

Neder

Fuld

Overend³

et al. 2007

Respiratory Medicine

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Effects of exercise and β₂-agonists on lung function in chronic obstructive pulmonary disease

Abstract: . Effects of exercise and ␤2-agonists on lung function in chronic obstructive pulmonary disease.

Cited by 9 publications

References 34 publications

Small airway morphology and lung function in the transition from normality to chronic airway obstruction

Small airway morphology and lung function in the transition from normality to chronic airway obstruction

How to interpret reduced forced expiratory volume in 1 s (FEV1)/vital capacity ratio with normal FEV1

Effects of formoterol on exercise tolerance in severely disabled patients with COPD

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Effects of exercise and β2-agonists on lung function in chronic obstructive pulmonary disease

Abstract: . Effects of exercise and ␤2-agonists on lung function in chronic obstructive pulmonary disease.

Cited by 9 publications

References 34 publications

Small airway morphology and lung function in the transition from normality to chronic airway obstruction

Small airway morphology and lung function in the transition from normality to chronic airway obstruction

How to interpret reduced forced expiratory volume in 1 s (FEV1)/vital capacity ratio with normal FEV1

Effects of formoterol on exercise tolerance in severely disabled patients with COPD

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Effects of exercise and β₂-agonists on lung function in chronic obstructive pulmonary disease