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Supernormal maximal mid-expirartory flow rates in diffuse interstitial lung disease

C S Tan, D P Tashkin

Respiration; International Review of Thoracic Diseases

|January 1, 1981

Summary

Supernormal maximal mid-expiratory flow rate (MMF) is more common in nonsmokers with diffuse interstitial lung disease (DILD). This finding in DILD patients suggests increased driving pressure and reduced peripheral airway resistance contribute to higher MMF.

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Area of Science:

Pulmonary Medicine
Respiratory Physiology

Background:

Diffuse interstitial lung disease (DILD) can affect lung function in various ways.
Maximal mid-expiratory flow rate (MMF) is a sensitive indicator of peripheral airway obstruction.

Purpose of the Study:

To investigate the frequency of altered maximal mid-expiratory flow rate (MMF) in patients with DILD.
To compare MMF patterns in nonsmokers with DILD, smokers with DILD, and healthy controls.

Main Methods:

Studied MMF, total lung capacity (TLC), forced vital capacity (FVC), and forced expired volume in 1 second (FEV1) in 32 nonsmokers with DILD, 22 smokers with DILD, and 36 healthy nonsmokers.
Assessed supernormal MMF/TLC and MMF/FVC ratios (greater than 120% of predicted).

Main Results:

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Supernormal MMF/TLC and MMF/FVC ratios were significantly more frequent in nonsmokers with DILD compared to healthy controls.
The prevalence of supernormal FEV1/FVC ratios did not differ significantly between groups.
In nonsmokers with DILD, a supernormal MMF/TLC ratio correlated with greater static lung recoil pressure (Pst).

Conclusions:

Increased MMF in nonsmokers with DILD may result from enhanced driving pressure for airflow.
Reduced resistance in peripheral airways likely contributes to the observed supernormal MMF in DILD patients.
MMF alterations provide insights into the complex physiological changes occurring in diffuse interstitial lung disease.