Premium
Prevalence and reversibility of lung hyperinflation in adult asthmatics with poorly controlled disease or significant dyspnea
Author(s) -
Perez T.,
Chanez P.,
Dusser D.,
Devillier P.
Publication year - 2016
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.12789
Subject(s) - medicine , salbutamol , functional residual capacity , asthma , lung volumes , hyperinflation , cardiology , dynamic hyperinflation , respiratory disease , lung , anesthesia , monetary policy , monetary economics , economics
Background In asthma, inflammation affects both the proximal and distal airways and may induce significant hyperinflation ( HI ). This study sought to evaluate the prevalence of HI in asthmatic patients with poorly controlled disease and/or dyspnea. Methods Poor asthma control was defined by an Asthma Control Test ( ACT ) score <20 ( n = 287), and dyspnea was defined as a modified Medical Research Council score ≥1 ( n = 18). HI was defined as either a residual volume/total lung capacity ( RV / TLC ) above the upper limit of normal ( RV ‐ HI ) or a functional residual capacity ( FRC ) >120% predicted ( FRC ‐ HI ). HI reversibility after administration of salbutamol (400 μg) was defined as a decrease in RV >20% or a reduction in FRC >10%. Changes in dyspnea and chest tightness were evaluated on a visual analogue scale. Results Both RV ‐ HI and FRC ‐ HI were observed in 48% of the 305 patients (mean ± SD age: 49 ± 17; FEV 1 : 75 ± 18% predicted) included in the study. The prevalence of HI was higher in patients with a FEV 1 <60% predicted (93% for RV ‐ HI and 71% for FRC ‐ HI , vs 21% and 41% in patients with a FEV 1 > 80%). In patients with HI , the ACT score was lower and chest tightness higher. HI reversibility was obtained in 38% of the asthmatics with FRC ‐ HI and 29% of the asthmatics with RV ‐ HI , whereas FEV 1 reversibility was obtained in half of these patients. Conclusions HI is highly prevalent in poorly controlled asthmatics suggesting small airway dysfunction and may represent an additional criteria for evaluating responsiveness to bronchodilators.