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Bronchial responsiveness to dry air hyperventilation in smokers may predict decline in airway status using indirect methods
Jönköping University, School of Health Science, HHJ. Biomedical Platform.
Rosenlund Primary Care Unit, Jönköping, 551 85, Sweden.
Division of Clinical Physiology, Department of Medicine and Health, Faculty of Health Sciences, Linköping University; and Department of Clinical Physiology, County Council of Östergötland, Linköping, Sweden.
2013 (English)In: Lung, ISSN 0341-2040, E-ISSN 1432-1750, Vol. 191, no 2, 183-190 p.Article 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, 183-190 p.
Keyword [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: diva2:696024
Available from: 2014-02-12 Created: 2014-02-12 Last updated: 2014-03-07Bibliographically approved

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