Bronchial responsiveness to dry air hyperventilation in smokers may predict decline in airway status using indirect methods
2013 (English)In: Lung, ISSN 0341-2040, E-ISSN 1432-1750, Vol. 191, no 2, p. 183-190Article in journal (Refereed) Published
Abstract [en]
Background
Disabling respiratory symptoms and rapid decline of lung function may occur in susceptible tobacco smokers. Bronchial hyperresponsiveness (BHR) elicited by direct challenge methods predicts worse lung function outcomes. The aim of this study was to evaluate whether BHR to isocapnic hyperventilation of dry air (IHDA) was associated with rapid deterioration in airway status and respiratory symptoms.
Methods
One hundred twenty-eight smokers and 26 age- and sex-matched healthy individuals with no history of smoking were investigated. All subjects completed a questionnaire. Spirometry and impulse oscillometry (IOS) measurements were recorded before and after 4 min of IHDA. The tests were repeated after 3 years in 102 smokers and 11 controls.
Results
Eighty-five smokers (66 %) responded to the challenge with a ≥2.4-Hz increase in resonant frequency (F res), the cutoff limit defining BHR, as recorded by IOS. They had higher F res at baseline compared to nonresponding smokers [12.8 ± 3.2 vs. 11.5 ± 3.4 Hz (p < 0.05)] and lower FEV1 [83 ± 13 vs. 89 ± 13 % predicted (p < 0.05)]. Multivariable logistic regression analysis indicated that wheezing (odds ratio = 3.7, p < 0.01) and coughing (odds ratio = 8.1, p < 0.05) were significantly associated with hyperresponsiveness. An increase in F res was recorded after 3 years in responding smokers but not in nonresponders or controls. The difference remained when subjects with COPD were excluded.
Conclusions
The proportion of hyperresponsive smokers was unexpectedly high and there was a close association between wheezing and coughing and BHR. Only BHR could discriminate smokers with rapid deterioration of airway status from others.
Place, publisher, year, edition, pages
2013. Vol. 191, no 2, p. 183-190
Keywords [en]
Bronchial hyperresponsiveness, Impulse oscillometry, Isocapnic hyperventilation of dry air, Resonant frequency, Tobacco smoke
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:hj:diva-23466DOI: 10.1007/s00408-012-9448-yOAI: oai:DiVA.org:hj-23466DiVA, id: diva2:696024
2014-02-122014-02-122017-12-06Bibliographically approved