Tidal expiratory flow limitation, dyspnoea and exercise capacity in patients with bilateral bronchiectasis

Abstract

In this study the authors investigated whether expiratory flow limitation (FL) is present during tidal breathing in patients with bilateral bronchiectasis (BB) and whether it is related to the severity of chronic dyspnoea (Medical Research Council (MRC) dyspnoea scale), exercise capacity (maximal mechanical power output (WRmax)) and severity of the disease, as assessed by high-resolution computed tomography (HRCT) scoring.Lung function, MRC dyspnoea, HRCT score, WRmax and FL were assessed in 23 stable caucasian patients (six males) aged 56¡17 yrs. FL was assessed at rest both in seated and supine positions. To detect FL, the negative expiratory pressure (NEP) technique was used. The degree of FL was rated using a five-point FL score. WRmax was measured using a cyclo-ergometer.According to the NEP technique, five patients were FL during resting breathing when supine but not seated, four were FL both seated and supine, and 14 were NFL both seated and supine. Furthermore, it was shown that: 1) in stable BB patients FL during resting breathing is common, especially in the supine position; 2) the degree of MRC dyspnoea is closely related to the five-point FL score; 3) WRmax (% pred) is more closely correlated with the MRC dyspnoea score than with the five-point FL score; and 4) HRCT score is closely related to forced expiratory volume in one second % pred but not five-point FL score.In conclusion, flow limitation is common at rest in sitting and supine positions in patients with bilateral bronchiectasis. Flow limitation and reduced exercise capacity are both associated with more severe dyspnoea. Finally, high-resolution computed tomography scoring correlates best with forced expiratory volume in one second. Eur Respir J 2003; 21: 743-748.

Impact of Cystic versus Cylindrical Types of Bronchiectasis on Pulmonary and Cardiac Functions

“…We also found a negative correlation between HRCT score and FEV1%. This is in agreement with previous reports; as the HRCT score reflects bronchiolitis, areas of emphysema, bullae, and bronchiectatic segments [20]-all can affect FEV1% measurements [21].…”

Impact of Different Etiologies of Bronchiectasis on the Pulmonary Function Tests

“…The reduction of the DLco (that occurred in 47.3% of our sample) has been associated with more advanced stages of disease, which might possibly be a relevant characteristic of our sample. 40 1 and FVC in individuals with post-tuberculosis bronchiectasis might be due to a greater severity and intensity of the bronchial and parenchymal damage; in addition, the reduced FVC might denote an airway obstruction by mucus or an airway collapse. 18 Conversely, the course of bronchiectasis due to repetitive pneumonia is milder, with a low degree of underlying fibrosis, and is almost always located in the same lung area.…”

The Efficacy of Flutter® and Active Cycle of Breathing Techniques in Patients with Bronchiectasis: A Prospective, Randomized, Comparative Study

“…Since the clinical course of bronchiectasis may display significant variability, prediction of respiratory function abnormalities is not possible. Patients with airway obstruction comprise the majority of cases [20]. Also, the effect of physiotherapy on PFT is a matter of controversy.…”