Effect of bronchial thermoplasty on static and dynamic lung compliance and resistance in patients with severe persistent asthma - 12/08/23
, Richard Barbers a, Darren May aAbstract |
Rationale |
Bronchial thermoplasty (BT) reduces severity and frequency of bronchoconstriction and symptoms in severe, persistent asthmatics although it is usually not associated with change in spirometric variables. Other than spirometry. there are almost no data on changes in lung mechanics following BT.
Objective |
To assess lung static and dynamic lung compliance (Cst,L and Cdyn,L, respectively) and static and dynamic lung resistance (Rst,L and Rdyn,L, respectively) before and after BT in severe asthmatics using the esophageal balloon technique.
Methods |
Rdyn,L and Cdyn,L were measured at respiratory frequencies up to 145 breaths/min, using the esophageal balloon technique in 7 patients immediately before and 12–50 weeks after completing a series of 3 BT sessions.
Results |
All patients experienced improved symptoms within a few weeks following completion of BT. Pre-BT, all patients exhibited frequency dependency of lung compliance, with mean Cdyn,L decreasing to 63% of Cst,L at maximum respiratory rates. Post-BT, Cst,L did not change significantly from pre-thermoplasty values, while Cdyn,L diminished to 62%% of Cst,L. In 4 of 7 patients, post-BT values of Cdyn,L were consistently higher than pre-BT over the range of respiratory rates. RL in 4 of 7 patients during quiet breathing and at higher respiratory frequencies decreased following BT.
Conclusions |
Patients with severe persistent asthma exhibit increased resting lung resistance and frequency dependence of compliance, the magnitudes of which are ameliorated in some patients following bronchial thermoplasty and associated with variable change in frequency dependence of lung resistance. These findings are related to asthma severity and may be related to the heterogeneous and variable nature of airway smooth muscle modeling and its response to BT.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Bronchial thermoplasty (BT) reduces airway smooth muscle (ASM) in severe asthma. |
• | Frequency dependence of lung mechanics were measured before and after BT. |
• | Frequency dependence of lung compliance was unchanged following BT. |
• | Decrease in frequency dependence of lung resistance was variable following BT. |
• | Findings are likely related to heterogeneity of ASM remodeling and response to BT. |
Keywords : Airway smooth muscle remodeling, Asthma, Bronchial thermoplasty, Esophageal balloon technique, Frequency dependence of compliance and resistance, Regional lung inhomogeneities
Plan
Vol 217
Article 107341- octobre 2023 Retour au numéro
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