Overall Contribution of Chest Wall Hyperinflation to Breathlessness in Asthma

Mario Filippelli, Roberto Duranti, Francesco Gigliotti, Roberto Bianchi, Michele Grazzini, Loredana Stendardi, Giorgio Scano

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Studies suggest that the increased volume of both abdominal and rib cage compartments of the chest wall contribute to dyspnea during methacholine-induced airway narrowing. Material: Eight male patients with asthma aged 34 ± 13 years (mean ± SD) before and during methacholine challenge. Methods: The volume of the chest wall (Vcw), volume of the abdomen (Vab), and volume of the rib cage (Vrc) were measured by using a three-dimensional optoelectronic plethysmography. Results: During methacholine challenge, the increase in end-expiratory Vcw (Vcw,ee) [0.55 ± 0.23 L, p <0.001] was due to increased Vrc (0.37 ± 0.20 L, p <0.01) and, to a lesser extent, Vab (0.18 ± 0.10 L, p <0.005). Linear univariate regression analysis showed that changes in dyspnea (Borg scale) with the highest methacholine dose correlated with both ΔFEV 1 and ΔVcw,ee. Multiple regression analysis with the Borg score as dependent variable and all other ventilatory indexes as independent variables showed that ΔVcw,ee and ΔFEV 1 were the only significant contributors to the Borg score. Taken together Vcw,ee and FEV 1 explained 56% of variance in the Borg score (r 2 = 0.56), although Vcw,ee explained 48% of it. Conclusions: During methacholine challenge in patients with asthma, the overall increase in Vcw,ee is a better predictor of dyspnea that the reduction in FEV 1.

Original languageEnglish
Pages (from-to)2164-2170
Number of pages7
JournalChest
Volume124
Issue number6
DOIs
Publication statusPublished - Dec 2003

Keywords

  • Asthma
  • Chest wall
  • Dyspnea
  • Hyperinflation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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