Contribution of peripheral airway function to changes in FEV<sub>1</sub>/FVC and RV/TLC with aging

Htun, Christopher; Pope, Alun; Lahzami, Samir; Luo, Darren; Schoeffel, Robin E.; Farrow, Catherine; Phillips, Craig L.; Robinson, Paul D.; King, Gregory G.

doi:10.1152/japplphysiol.00114.2018

Cited by 9 publications

(10 citation statements)

References 27 publications

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“…Using an SF6 washout system, Fuchs et al also did not show any relationship between LCI and age up to 20 yrs [29]. On the other hand, lung elasticity declines with age, and this is associated with increases in FEV 1 /FVC, increased trapped gas (RV/TLC), and increases in a number of markers of ventilation heterogeneity including LCI [19]. Kjellberg et al reported on nitrogen-LCI from 400 healthy adult controls up to the age of 71 years, measured using an Exhalyser D device [18].…”

Section: Discussionmentioning

confidence: 96%

“…Although mean LCI increased with age (0.5 units over 12yrs), this was less than described by Kjellberg in older subjects [18] and, similar to our approach, the authors concluded that a fixed ULN was appropriate. Htun et al and Verbanck et al have separately reported on nitrogen-LCI in similar populations using a different non-commercial nitrogen washout system [19,31,32]. The normal range for LCI in both cases was different, but in contrast to the Exhalyser D data, seemed to show relatively stable ULN for LCI below 40 years, with LCI only increasing above this age.…”

Section: Discussionmentioning

confidence: 96%

“…nitrogen or sulphur hexafluoride (SF 6 )) [13,14] as well as more subtle changes in equipment deadspace [15], gas analyser response time and signal alignment [16,17]. Studies in older adults using nitrogen washout have also indicated that, along with other markers of lung function and airway elasticity, there is an age-related increase in markers of ventilation heterogeneity, including nitrogen-LCI [18,19].…”

Section: Introductionmentioning

confidence: 99%

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Lung clearance index in healthy volunteers, measured using a novel portable system with a closed circuit wash-in

et al. 2020

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Introduction Lung clearance index (LCI) is a sensitive measure of early lung disease, but adoption into clinical practice has been slow. Challenges include the time taken to perform each test. We recently described a closed-circuit inert gas wash-in method that reduces overall testing time by decreasing the time to equilibration. The aim of this study was to define a normative range of LCI in healthy adults and children derived using this method. We were also interested in the feasibility of using this system to measure LCI in a community setting. Methods LCI was assessed in healthy volunteers at three hospital sites and in two local primary schools. Volunteers completed three washout repeats at a single visit using the closed circuit wash-in method (0.2% SF 6 wash-in tracer gas to equilibrium, room air washout). Results 160 adult and paediatric subjects successfully completed LCI assessment (95%) (100 in hospital, 60 in primary schools). Median coefficient of variation was 3.4% for LCI repeats and 4.3% for FRC. Mean (SD) LCI for the analysis cohort (n = 53, age 5-39 years) was 6.10 (0.42), making the upper limit of normal LCI 6.8. There was no relationship between LCI and multiple demographic variables. Median (interquartile range) total test time was 18.7 (16.0-22.5) minutes.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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Lung clearance index in healthy volunteers, measured using a novel portable system with a closed circuit wash-in

et al. 2020

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“…In contrast, in older people AHR is predicted by Sacin [78], suggesting the acinar rather than conductive airways contribute to ventilation heterogeneity in older people with asthma. It is worth noting that ventilation heterogeneity increases with age in health [79,80], with an accelerated increase seen in Sacin and LCI after the age of 60 years, versus a steady linear increase in Scond [80,81]. However, Sacin and LCI are both associated with loss of lung elastic recoil in elderly asthma independently of ageing [82].…”

Section: Relationship With Symptoms and Disease Statusmentioning

confidence: 99%

Dismantling airway disease with the use of new pulmonary function indices

2019

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We are currently limited in our abilities to diagnose, monitor disease status and manage chronic airway disease like asthma and chronic obstructive pulmonary disease (COPD). Conventional lung function measures often poorly reflect patient symptoms or are insensitive to changes, particularly in the small airways where disease may originate or manifest. Novel pulmonary function tests are becoming available which help us better characterise and understand chronic airway disease, and their translation and adoption from the research arena would potentially enable individualised patient care.In this article, we aim to describe two emerging lung function tests yielding novel pulmonary function indices, the forced oscillation technique (FOT) and multiple breath nitrogen washout (MBNW). With a particular focus on asthma and COPD, this article demonstrates how chronic airway disease mechanisms have been dismantled with the use of the FOT and MBNW. We describe their ability to assess detailed pulmonary mechanics for diagnostic and management purposes including response to bronchodilation and other treatments, relationship with symptoms, evaluation of acute exacerbations and recovery, and telemonitoring. The current limitations of both tests, as well as open questions/directions for further research, are also discussed.

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“…And increasing evidence shows that sex, age, and body mass status affect small airway function. 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 Among the subjects without airflow obstruction, aging is associated with functional small airway abnormality. 3 Changes in FEV1/FVC in healthy adults are associated with the changes in peripheral airway function with aging.…”

Section: Introductionmentioning

confidence: 99%

Association between age, gender, body mass index, and pulmonary function in preoperative patients with lung cancer

Liu

Zeng

et al. 2022

Clinical Respiratory J

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Introduction: Many confounding factors such as sex, age, and body mass index (BMI) affect pulmonary function parameters, but there are limited data about the direct and/or indirect effects of small airway function on lung function for differences in confounding factors.Objectives: This study aimed to use structural equation model (SEM) to explain the influence of the confounding factors (age, sex, and BMI) on the relationship between small airway function and lung function in patients with lung cancer. Methods: A cross-sectional observational study was conducted in a single medical center. Subjects were assessed; small airway function was specified by MEF25% and MEF50%; lung function by FVC; pulmonary obstruction by FEV1, FEV1%, and FEV1/FVC; and PEF and PEF% reflected the strength of abdominal muscles. The measurement model was analyzed by confirmatory factor analysis. The SEM was conducted to analyze the structural models of the effects of the confounding factors. Results: In the measurement model, variables were fit to their domains, the path linking age and sex to pulmonary obstruction was positive and statistically significant, and the path linking sex to muscle strength was also positive and statistically significant. Muscle strength positively and significantly mediates the path between sex and FVC. As a moderator, BMI increased the effects of small airway function on FVC. Conclusion:Age and sex were directed to pulmonary obstruction, and muscle strength as a mediator between sex and lung function was novel, and BMI adjusted the effects of small airway function on FVC.

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Contribution of peripheral airway function to changes in FEV₁/FVC and RV/TLC with aging

Cited by 9 publications

References 27 publications

Lung clearance index in healthy volunteers, measured using a novel portable system with a closed circuit wash-in

Lung clearance index in healthy volunteers, measured using a novel portable system with a closed circuit wash-in

Dismantling airway disease with the use of new pulmonary function indices

Association between age, gender, body mass index, and pulmonary function in preoperative patients with lung cancer

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Contribution of peripheral airway function to changes in FEV1/FVC and RV/TLC with aging

Cited by 9 publications

References 27 publications

Lung clearance index in healthy volunteers, measured using a novel portable system with a closed circuit wash-in

Lung clearance index in healthy volunteers, measured using a novel portable system with a closed circuit wash-in

Dismantling airway disease with the use of new pulmonary function indices

Association between age, gender, body mass index, and pulmonary function in preoperative patients with lung cancer

Contact Info

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Contribution of peripheral airway function to changes in FEV₁/FVC and RV/TLC with aging