Prevalence of small airways dysfunction in asthma with- and without-fixed airflow obstruction and chronic obstructive pulmonary disease

Pornsuriyasak, Prapaporn; Khiawwan, Supattra; Rattanasiri, Sasivimol; Unwanatham, Nattawut; Petnak, Tananchai

doi:10.12932/ap-310119-0485

Cited by 6 publications

(18 citation statements)

References 23 publications

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“…At the same time, IPF patients without SAD had no bronchodilator effect. The thresholds for the bronchodilatory test using FOT parameters are a 40% decrease in R and a 50% increase in X [58]. Similarly in COVID survivors, even when spirometry was normal, changes in oscillometric parameters were detected [59].…”

Section: Discussionmentioning

confidence: 96%

Forced Oscillation Measurements in Patients with Idiopathic Interstitial Pneumonia Subjected to Pulmonary Rehabilitation

Kostorz‐Nosal

Jastrzębski

Kubicki

et al. 2022

JCM

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(1) Background: Pulmonary rehabilitation (PR) plays a significant therapeutic role for patients with idiopathic interstitial pneumonia (IIP). The study assessed the impact of physical activity on lung function measured by forced oscillation technique (FOT). (2) Methods: The study involved 48 patients with IIP subjected to a 3-week inpatient PR. The control group included IIP patients (n = 44) on a 3-week interval without PR. All patients were assessed at baseline and after 3 weeks of PR by FOT, spirometry, plethysmography, grip strength measurement and the 6-minute walk test. (3) Results: There were no significant changes in FOT measurements in the PR group, except for reduced reactance at 11 Hz, observed in both groups (p < 0.05). Patients who completed PR significantly improved their 6-min walk distance (6MWD) and forced vital capacity (FVC). The change in 6MWD was better in patients with higher baseline reactance (p = 0.045). (4) Conclusions: Patients with IIP benefit from PR by an increased FVC and 6MWD; however, no improvement in FOT values was noticed. Slow disease progression was observed in the study and control groups, as measured by reduced reactance at 11 Hz. Patients with lower baseline reactance limitations achieve better 6MWD improvement.

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Section: Discussionmentioning

confidence: 96%

Forced Oscillation Measurements in Patients with Idiopathic Interstitial Pneumonia Subjected to Pulmonary Rehabilitation

Kostorz‐Nosal

Jastrzębski

Kubicki

et al. 2022

JCM

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“…Currently, there is a variety of definitions of FAO used in clinical practice and medical research including use of pre- and/or post-bronchodilator spirometry values, Forced Expiratory Volume in the 1 st second/Forced Vital Capacity ratio (FEV 1 /FVC), absolute or relative cutoffs as well delineation based on the absence of a bronchodilator response alone. Spirometry predominantly assesses the flow of larger more central airways and is not a sensitive measure of the small peripheral airway dysfunction and abnormal mechanical properties of lung tissue that contribute to the pathogenesis of severe asthma [ 8 , 9 ]. In order to assess the small airways and parenchyma in asthma, a number of different techniques have been used [ 8 , 9 , 10 ].…”

Section: Fixed Airflow Obstruction: Is It Due To Asthma Copd or Asthm...mentioning

confidence: 99%

“…Spirometry predominantly assesses the flow of larger more central airways and is not a sensitive measure of the small peripheral airway dysfunction and abnormal mechanical properties of lung tissue that contribute to the pathogenesis of severe asthma [ 8 , 9 ]. In order to assess the small airways and parenchyma in asthma, a number of different techniques have been used [ 8 , 9 , 10 ]. Oscillometry, increasingly utilized both in clinical practice and medical research, does not require effort to force expiration that may affect small airway closure and can differentiate if an increase in the total resistance is located at central or at peripheral airways.…”

Section: Fixed Airflow Obstruction: Is It Due To Asthma Copd or Asthm...mentioning

confidence: 99%

“…Oscillometry, increasingly utilized both in clinical practice and medical research, does not require effort to force expiration that may affect small airway closure and can differentiate if an increase in the total resistance is located at central or at peripheral airways. The prevalence of increased small airway resistance using oscillometry has been found to be significantly higher in asthmatic patients with FAO and COPD than in asthmatics without FAO [ 9 ]. In addition, the presence of abnormal post-bronchodilator reactance in oscillometry has been related to low asthma control in asthma patients with FAO and contributed in identifying 25% more patients with poor asthma control compared to spirometry parameters alone [ 10 ].…”

Section: Fixed Airflow Obstruction: Is It Due To Asthma Copd or Asthm...mentioning

confidence: 99%

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Asthma with Fixed Airflow Obstruction: From Fixed to Personalized Approach

Bakakos

Vogli

Dimakou

et al. 2022

JPM

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Asthma is generally characterized by variable symptoms such as dyspnea and wheezing and variable airflow obstruction. This review focuses on a subset of patients suffering from asthma with persistent airflow limitation that is not fully reversible (asthma with fixed airflow obstruction, FAO). The pathophysiology, the risk factors and the clinical outcomes associated with FAO are presented, as well as the distinct clinical entity of severe asthma and its inflammatory subtypes (T2 and non-T2). The current strategies for the treatment of these endotypes and treatment of the distinct Asthma/COPD overlap (ACO) phenotype are described. Management and medical interventions in FAO and/or ACO patients demand a holistic approach, which is not yet clearly established in guidelines worldwide. Finally, a treatment algorithm that includes FAO/ACO management based on pharmacological and non-pharmacological treatment, guideline-based management for specific co-morbidities, and modification of the risk factors is proposed.

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“…In asthma, a systematic review showed that the prevalence of SAD in asthma ranged from 33.0 to 69.9% when using IOS ( 22 ). In one study, the prevalence of SAD by using fixed R5–R20 criteria ≥0.075 kPa/L/s in COPD, asthma with FAO, and asthma without FAO were 68, 95, and 77%, respectively ( 21 ). By using spirometry, Manoharan et al found that 54% of asthma had SAD defined using FEF25–75% of <60% predicted ( 29 ).…”

Section: Introductionmentioning

confidence: 99%

Comparative assessment of small airway dysfunction by impulse oscillometry and spirometry in chronic obstructive pulmonary disease and asthma with and without fixed airflow obstruction

2023

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BackgroundSmall airways play a major role in the pathogenesis and prognosis of chronic obstructive pulmonary disease (COPD) and asthma. More data on small airway dysfunction (SAD) using spirometry and impulse oscillometry (IOS) in these populations are required. The objective of this study was to compare the two methods, spirometry and IOS, for SAD detection and its prevalence defined by spirometry and IOS in subjects with COPD and asthma with and without fixed airflow obstruction (FAO).DesignThis is a cross-sectional study.MethodsSpirometric and IOS parameters were compared across four groups (COPD, asthma with FAO, asthma without FAO, and healthy subjects). SAD defined by spirometry and IOS criteria were compared.ResultsA total of 262 subjects (67 COPD, 55 asthma with FAO, 101 asthma without FAO, and 39 healthy controls) were included. The prevalence of SAD defined by using IOS and spirometry criteria was significantly higher in patients with COPD (62.7 and 95.5%), asthma with FAO (63.6 and 98.2%), and asthma without FAO (38.6 and 19.8%) in comparison with healthy control (7.7 and 2.6%). IOS is more sensitive than spirometry in the detection of SAD in asthma without FAO (38.6% vs. 19.8%, p = 0.003) However, in subjects with FAO (COPD and asthma with FAO), spirometry is more sensitive than IOS to detect SAD (95.5% vs. 62.7%, p < 0.001 and 98.2% vs. 63.6%, p < 0.001, respectively).ConclusionSmall airway dysfunction was significantly detected in COPD and asthma with and without FAO. Although IOS shows more sensitivity than spirometry in the detection of SAD in asthma without FAO, spirometry is more sensitive than IOS in patients with FAO including COPD and asthma with FAO.

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Prevalence of small airways dysfunction in asthma with- and without-fixed airflow obstruction and chronic obstructive pulmonary disease

Cited by 6 publications

References 23 publications

Forced Oscillation Measurements in Patients with Idiopathic Interstitial Pneumonia Subjected to Pulmonary Rehabilitation

Forced Oscillation Measurements in Patients with Idiopathic Interstitial Pneumonia Subjected to Pulmonary Rehabilitation

Asthma with Fixed Airflow Obstruction: From Fixed to Personalized Approach

Comparative assessment of small airway dysfunction by impulse oscillometry and spirometry in chronic obstructive pulmonary disease and asthma with and without fixed airflow obstruction

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