Frequency dependence of dynamic compliance in patients with rheumatoid arthritis.

Hills, Elizabeth A.; Davies, Steffan; Geary, Marion

doi:10.1136/thx.34.6.755

Cited by 14 publications

(5 citation statements)

References 19 publications

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“…The mean values of Crs,dyn in the RA patients were significantly smaller than in the normal subjects, which indicates the presence of restrictive alterations ( Figure 2D ). This finding is in agreement with the increase in the frequency dependence of dynamic compliance (FDC) observed by Hills et al ( 37 ) in RA patients. The cited authors attributed this decrease in compliance to differing time constants throughout the lung.…”

Section: Discussionsupporting

confidence: 93%

“…The cited authors attributed this decrease in compliance to differing time constants throughout the lung. In RA disease, FDC could be due either to bronchiolar involvement that causes changes in resistance or to the uneven involvement of the alveoli and connective tissues as a result of the inflammatory or fibrotic changes of fibrosing alveolitis, leading to scattered areas of altered compliance ( 37 ). These changes in the connective tissues could potentially explain the differences in the reactance values at all frequencies in the RA patients ( Figure 1B ).…”

Section: Discussionmentioning

confidence: 99%

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Contrasting diagnosis performance of forced oscillation and spirometry in patients with rheumatoid arthritis and respiratory symptoms

Faria¹,

do²,

Lopes³

et al. 2012

Clinics

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OBJECTIVES:Pulmonary involvement in rheumatoid arthritis is directly responsible for 10% to 20% of all mortality. The best way to improve the prognosis is early detection and treatment. The forced oscillation technique is easy to perform and offers a detailed exam, which may be helpful in the early detection of respiratory changes. This study was undertaken to (1) evaluate the clinical potential of the forced oscillation technique in the detection of early respiratory alterations in rheumatoid arthritis patients with respiratory complaints and (2) to compare the sensitivity of forced oscillation technique and spirometric parameters.METHODS:A total of 40 individuals were analyzed: 20 healthy and 20 with rheumatoid arthritis (90% with respiratory complaints). The clinical usefulness of the parameters was evaluated by investigating the sensibility, the specificity and the area under the receiver operating characteristic curve. ClinicalTrials.gov: NCT01641705.RESULTS:The early adverse respiratory effects of rheumatoid arthritis were adequately detected by the forced oscillation technique parameters, and a high accuracy for clinical use was obtained (AUC>0.9, Se = 80%, Sp = 95%). The use of spirometric parameters did not obtain an appropriate accuracy for clinical use. The diagnostic performance of the forced oscillation technique parameters was significantly higher than that of spirometry.CONCLUSIONS:The results of the present study provide substantial evidence that the forced oscillation technique can contribute to the easy identification of initial respiratory abnormalities in rheumatoid arthritis patients that are not detectable by spirometric exams. Therefore, we believe that the forced oscillation technique can be used as a complementary exam that may help to improve the treatment of breathing disorders in rheumatoid arthritis patients.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Contrasting diagnosis performance of forced oscillation and spirometry in patients with rheumatoid arthritis and respiratory symptoms

Faria¹,

do²,

Lopes³

et al. 2012

Clinics

View full text Add to dashboard Cite

show abstract

“…On the other hand, in many comparative studies with normal controls, increased incidence of airway obstruction was not found in RA patients, and in cases where obstruction was observed they were attributed to specific etiologies like smoking, denying the possibility that the obstruction was due to RA itself 10 , 25 , 26 ) .…”

Section: Discussionmentioning

confidence: 98%

Small Airway Disease in Rheumatoid Arthritis

Lee

Suh

Lee

et al. 1992

Korean J Intern Med

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Variety of pulmonary lesions are thought to be associated with rheumatoid arthritis (RA). These lesions traditionally have included pleurisy with or without effusion, Caplan’s syndrome, pulmonary rheumatoid nodules, diffuse interstitial fibrosis, and pulmonary arteritis and hypertension. But little attention has been paid to the airways in RA. Recently, several repots have suggested an association between airflow limitation and RA, but its incidence is not known. Also whether there exists a parameter of disease activity of RA, suggesting the presence of small airway disease (SAD) is not clear.To answer these questions, the serologic parameters which reflect the disease activity of RA and pulmonary function tests which reflect small airway dysfunction were performed on 36 lifetime nonsmokers with RA who had normal chest x-ray findings. The prevalence of SAD and the relationships between the disease activity parameters of RA and pulmonary function were observed.The results were as follows. The percentages of patients with abnormal values for diffusing capacity, frequency dependence of compliance (C1.0/C0.0), forced expiratory flow25–75%, Vmax50% and Vmax75% were 45.5%, 62.5%, 40%, 22.8% and 11.4%, respectively. There was statistically significant negative correlation between C1.0/C0.0 and ESR. But consistent correlation between other pulmonary function tests and clinical and serologic parameters of RA, and differences in pulmonary function between patients who were serologically positive and negative for CRP and FANA, were not found.In conclusion, SAD, without the influence of smoking, is frequently associated with RA, but, the presence of SAD cannot be predicted from any clinical and seologic parameters of RA currently in use.

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“…Moreover, Hills et al (1979) indicated that if frequency dependence of dynamic compliance not accompanied by other abnormalities is found in RA patients, it may serve as a sign to detect early lung disease. The present study also showed that patients with MCTD have impairment of small airways in the relatively early stages of the disease.…”

Section: Resultsmentioning

confidence: 99%

“…Pulmonary function tests in these patients, especially in those with PSS and RA, often show restrictive and/or obstructive damage and, recently, small airway impairments (Collins et al 1976; Guttadauria et al 1977; Bagg and Hughes 1979;Hills et al 1979; Hunninghake and Fauci 1979; Begin et al 1982; Mountz et al 1984). Moreover, it has been reported that diffusing capacity is frequently decreased in MCTD patients (Sharp 1974(Sharp -1975Singsen et al 1977; Wiener-Kronish et al 1981; Sullivan et al 1984; Takasaki et al 1984; Derderian et al 1985; Prakash et al 1985), but there are few studies concerning the small airways.…”

mentioning

confidence: 99%

Small Airway Involvement in Mixed Connective Tissue Disease.

Izumiyama

Hida

Ichinose

et al. 1993

Tohoku J. Exp. Med.

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We studied pulmonary functions in 17 female patients with mixed connective tissue disease (MCTD) to detect early pulmonary involvement in this disease; in 8 of the 17 patients followup studies were also performed at 1.2-to 5.9-year intervals. In the first pulmonary function tests, decreases in vital capacity (VC) and diffusing capacity (DL~o) were observed in 6 (35%) and 8 (47%) patients, respectively. The ratio of forced expiratory volume in one second to VC was normal in all the patients, but pulmonary resistance and static compliance were abnormal in 6 (35%) and 10 (59%) patients, respectively. However, frequency dependence of dynamic compliance was found in all 16 patients tested. Moreover, 4 (24%) of the 17 patients had normal DL~o and DL~o-to-alveolar volume ratio (DLCO/VA). Reductions in DL~o and DLCo/VA were significantly correlated with the disease duration. These results suggest that small airway obstruction is an early and frequent indication of functional pulmonary impairment, and that impairment of alveolar gas exchange is progressive in patients with MCTD.connective tissue disease; small airways; frequency dependence of dynamic compliance; diffusing capacity

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Frequency dependence of dynamic compliance in patients with rheumatoid arthritis.

Cited by 14 publications

References 19 publications

Contrasting diagnosis performance of forced oscillation and spirometry in patients with rheumatoid arthritis and respiratory symptoms

Contrasting diagnosis performance of forced oscillation and spirometry in patients with rheumatoid arthritis and respiratory symptoms

Small Airway Disease in Rheumatoid Arthritis

Small Airway Involvement in Mixed Connective Tissue Disease.

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