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Unsuspected pseudophysiologic emphysema in chronic persistent asthma.

A F Gelb1, N Zamel

  • 1Pulmonary Division, Department of Medicine, Lakewood Regional Medical Center, University of California, Los Angeles, CA, USA. afgelb@msn.com

American Journal of Respiratory and Critical Care Medicine
|November 9, 2000
PubMed
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Chronic persistent asthma significantly reduces lung elastic recoil, contributing to airflow limitation. This unexpected finding in asthma patients highlights the need to emphasize its role in lung function impairment.

Area of Science:

  • Pulmonary Medicine
  • Respiratory Physiology

Background:

  • Chronic persistent asthma is linked to airway remodeling and fixed expiratory airflow limitation.
  • The precise mechanisms underlying airflow limitation in asthma require further elucidation.

Purpose of the Study:

  • To investigate the role of lung elastic recoil in fixed expiratory airflow limitation in adults with chronic persistent asthma.
  • To examine the contribution of reduced lung elastic recoil to airflow obstruction.

Main Methods:

  • Studied 18 adults with chronic persistent asthma and fixed expiratory airflow obstruction.
  • Measured maximal expiratory flow-volume curves, lung elastic recoil, and diaphragmatic strength.
  • Utilized lung computed tomography (CT) and assessed lung volumes (RV, FRC, TLC).

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Main Results:

  • All subjects exhibited abnormal maximal expiratory flow-volume curves and hyperinflation.
  • A significant loss of lung elastic recoil was observed across various age groups.
  • Reduced lung elastic recoil accounted for substantial reductions in maximal expiratory airflow, particularly at lower lung volumes.

Conclusions:

  • Loss of lung elastic recoil is a significant, unexpected finding in chronic persistent asthma.
  • Reduced lung elastic recoil plays a crucial role in the airflow limitation observed in these patients.
  • The underlying mechanisms causing loss of lung elastic recoil in asthma remain to be identified.