Frequency dependence of ventilation distribution in normal and obstructed lungs

Differences in regional pulmonary time constant may cause ventilation distribution to vary with breathing frequency and frequency-dependent changes in regional ventilation per unit volume might be expected. We measured the regional distribution of inhaled xenon-133 (133Xe) at 10 and 60 breaths/min in normal subjects and in patients with a clinical diagnosis of chornic bronchitis or asthma. Breathing frequency had no siqnificant effect on ventilation distribution in normals but in patients with chronic bronchitis ventilation decreased in the lower lung regions at 60 breaths/min compared with 10 breaths/min. In six asthmatic patients the lung regions demonstrating the greatest frequency-dependent reductions in ventilation, which were assumed to have the greatest time constants, also showed decreased ventilation-perfusion ratios (V/Q) measured by standard 133Xe techniques. Bronchodilator increased ventilation more than perfusion in these regions and thus V/Q ratio increased toward the normal range. These results imply that measurement of the frequency dependence of regional ventilation provides information about the relative distribution of airway obstruction, and that airway function in the most obstructed lung regions in asthmatics is improved following bronchodilator therapy.