Is Lung Clearance Index (LCI) Affected by the Severity of Lung Disease in CF?

Avramidou, Vasiliki; Hatziagorou, Elpis; Kampouras, Asterios; Georgopoulou, Vasiliki; Kirvasilis, Fotis; Tsanakas, John

doi:10.4172/2161-105x.1000392

Cited by 5 publications

(5 citation statements)

References 68 publications

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“…38 In smokers with normal spirometry, changes in S cond were found and improvements to normal remained 12 months after smoking cessation. 39 These findings are supported by data in patients with cystic fibrosis 40 and adults with asthma. 41 covered by either S cond or S acin .…”

Section: Discussionsupporting

confidence: 53%

Multiple breath washout (MBW) testing using sulfur hexafluoride: reference values and influence of anthropometric parameters

Maros

Roth

Hermanns

et al. 2021

Thorax

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BackgroundMultiple breath washout (MBW) using sulfur hexafluoride (SF6) has the potential to reveal ventilation heterogeneity which is frequent in patients with obstructive lung disease and associated small airway dysfunction. However, reference data are scarce for this technique and mostly restricted to younger cohorts. We therefore set out to evaluate the influence of anthropometric parameters on SF6-MBW reference values in pulmonary healthy adults.MethodsWe evaluated cross-sectional data from 100 pulmonary healthy never-smokers and smokers (mean 51 (SD 20), range 20–88 years). Lung clearance index (LCI), acinar (Sacin) and conductive (Scond) ventilation heterogeneity were derived from triplicate SF6-MBW measurements. Global ventilation heterogeneity was calculated for the 2.5% (LCI2.5) and 5% (LCI5) stopping points. Upper limit of normal (ULN) was defined as the 95th percentile.ResultsAge was the only meaningful parameter influencing SF6-MBW parameters, explaining 47% (CI 33% to 59%) of the variance in LCI, 32% (CI 18% to 47%) in Sacin and 10% (CI 2% to 22%) in Scond. Mean LCI increases from 6.3 (ULN 7.4) to 8.8 (ULN 9.9) in subjects between 20 and 90 years. Smoking accounted for 2% (CI 0% to 8%) of the variability in LCI, 4% (CI 0% to 13%) in Sacin and 3% (CI 0% to 13%) in Scond.ConclusionSF6-MBW outcome parameters showed an age-dependent increase from early adulthood to old age. The effect was most pronounced for global and acinar ventilation heterogeneity and smaller for conductive ventilation heterogeneity. No influence of height, weight and sex was seen. Reference values can now be provided for all important SF6-MBW outcome parameters over the whole age range.Trial registration numberNCT04099225.

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Section: Discussionsupporting

confidence: 53%

Multiple breath washout (MBW) testing using sulfur hexafluoride: reference values and influence of anthropometric parameters

Maros

Roth

Hermanns

et al. 2021

Thorax

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“…A normal LCI can, in most cases, exclude the presence of HRCT abnormalities ( 3 , 22 ). LCI has been found to relate in particular to the extent of bronchiectasis, and the presence of mucus plugging and emphysema ( 36 ). Such findings suggest that routine use of LCI is a reliable alternative to CT as a first line investigation to exclude lung damage whilst minimizing radiation exposure.…”

Section: Lung Clearance Index Lcimentioning

confidence: 99%

Toward the Establishment of New Clinical Endpoints for Cystic Fibrosis: The Role of Lung Clearance Index and Cardiopulmonary Exercise Testing

et al. 2021

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As Cystic Fibrosis (CF) treatment advances, research evidence has highlighted the value and applicability of Lung Clearance Index and Cardiopulmonary Exercise Testing as endpoints for clinical trials. In the context of these new endpoints for CF trials, we have explored the use of these two test outcomes for routine CF care. In this review we have presented the use of these methods in assessing disease severity, disease progression, and the efficacy of new interventions with considerations for future research.

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“…It has been shown that, in most cases, a normal LCI can rule out the presence of anomalies observed at HRCT [29,30]. LCI has also been found to relate in particular to the extent of bronchiectasis, and the presence of mucus plugging and emphysema [31]. These findings may open to the suggestion of routine using of LCI as a reliable alternative to HRCT as a first line exam to rule out lung injury while minimising radiation exposure.…”

Section: The Physiological Clinical and Prognostic Value Of The Ventilatory Efficiency In Adults With Cfmentioning

confidence: 96%

Ventilatory efficiency and its clinical and prognostic value in adults with cystic fibrosis

Laveneziana

Palange

2021

Eur Respir Rev

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Cystic fibrosis, due to the absence or abnormal function of the cystic fibrosis transmembrane conductance regulator, is the most common life-limiting autosomal recessive genetic disorder among the Caucasian population. The lungs are particularly affected due to thick and tenacious mucus causing parenchymal anomalies ranging from bronchiectasis, progressive airflow limitation, respiratory infections, lung destruction and ultimately respiratory failure. Despite the remarkable advances in treatment that have greatly improved survival, most patients experience progressive exercise curtailment, with the consequence that a growing number of patients with cystic fibrosis will be referred for exercise-based evaluations in the forthcoming years. Cardiopulmonary exercise testing, in particular, is a useful tool to assess the mechanisms of exercise intolerance in individual patients that may have treatment and prognostic implications. In this review, we will focus on ventilatory efficiency and its clinical and prognostic value in adults with cystic fibrosis.

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Is Lung Clearance Index (LCI) Affected by the Severity of Lung Disease in CF?

Cited by 5 publications

References 68 publications

Multiple breath washout (MBW) testing using sulfur hexafluoride: reference values and influence of anthropometric parameters

Multiple breath washout (MBW) testing using sulfur hexafluoride: reference values and influence of anthropometric parameters

Toward the Establishment of New Clinical Endpoints for Cystic Fibrosis: The Role of Lung Clearance Index and Cardiopulmonary Exercise Testing

Ventilatory efficiency and its clinical and prognostic value in adults with cystic fibrosis

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