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Updated: May 8, 2026

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Published on: April 8, 2022
Visualized changes in respiratory resistance and reactance along a time axis in smokers: a cross-sectional study
Haruko Shinke1, Masatsugu Yamamoto, Nobuko Hazeki
1Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan.
Early respiratory impedance changes, including elevated resistance and altered reactance, are detectable in approximately 60% of smokers with normal lung function, suggesting potential early airway remodeling.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
Background:
- Early detection of respiratory dysfunction in smokers is crucial for preventing chronic obstructive pulmonary disease (COPD).
- Assessing respiratory impedance may reveal subtle changes in smokers before traditional lung function tests decline.
Purpose of the Study:
- To investigate alterations in respiratory impedance components (resistance and reactance) in smokers with normal FEV1/FVC ratios.
- To compare these impedance changes with those observed in nonsmokers and COPD patients.
Main Methods:
- Respiratory resistance and reactance were measured during both inspiratory and expiratory phases.
- Impedance components were compared across three groups: nonsmokers, smokers, and COPD patients.
Main Results:
- Approximately 60% of smokers exhibited elevated resistance and negative reactance shifts, particularly during exhalation.
- Smokers showed increased expiratory-inspiratory gaps in resistance and reactance compared to nonsmokers.
- Higher R5-R20 values were observed in smokers, correlating with specific measures of airflow limitation (V·50/V·25).
Conclusions:
- Significant respiratory impedance changes occur in a majority of smokers even with normal spirometry (FEV1/FVC).
- These findings suggest early small airway remodeling due to smoking.
- Respiratory impedance may serve as an early indicator for COPD development.
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