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Peripheral airway dysfunction and relationship with symptoms in smokers with preserved spirometry
Kanika Jetmalani1,2, Cindy Thamrin1,2, Claude S Farah1,2,3
1The Woolcock Emphysema Centre, Woolcock Institute of Medical Research, Glebe, NSW, Australia.
Respirology (Carlton, Vic.)
|November 16, 2017
Summary
Smokers with normal spirometry often have respiratory symptoms and peripheral airway dysfunction. Both multiple breath nitrogen washout (MBNW) and impulse oscillometry system (IOS) detected these abnormalities, but were unrelated.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
Background:
- Smokers frequently experience respiratory symptoms and peripheral airway dysfunction, even with normal spirometry.
- Multiple breath nitrogen washout (MBNW) and impulse oscillometry system (IOS) are emerging tools for assessing peripheral airway function.
- Direct comparison of MBNW and IOS in smokers with preserved spirometry is lacking.
Purpose of the Study:
- To investigate the prevalence and relationship of peripheral airway dysfunction, measured by MBNW and IOS, in smokers with normal spirometry.
- To determine if MBNW and IOS abnormalities are jointly present and associated with respiratory symptoms in this cohort.
Main Methods:
- Eighty smokers with normal spirometry underwent symptom questionnaires.
- Peripheral airway function was assessed using MBNW (measuring Sacin, Scond, %VtrFRC/VC) and IOS (measuring resistance and reactance at 5 and 20 Hz).
Main Results:
- 68% of subjects reported respiratory symptoms.
- 50% had abnormal MBNW parameters (primarily Sacin), and 51% had abnormal IOS parameters (primarily resistance).
- 76% exhibited abnormalities in either MBNW or IOS, though these were not correlated. Chronic bronchitis symptoms linked to Scond; wheeze linked to lower spirometry and increased IOS resistance.
Conclusions:
- Peripheral airway dysfunction and respiratory symptoms are common in smokers with normal spirometry.
- MBNW and IOS can detect these abnormalities, but their findings are not consistently related in this population.
- The clinical significance of these peripheral airway changes in smokers requires further investigation.
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