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Woolcock Institute of Medical Research and Cooperative Research Centre for Asthma, University of Sydney, Australia
CORRESPONDENCE: C. Salome, Woolcock Institute of Medical Research, Level 9, Building 82, Royal Prince Alfred Hospital, Camperdown 2050, Australia. Fax: 61 295506115. E-mail: cms@woolcock.org.au
Keywords: airway re-narrowing, asthma, deep inspiration, forced oscillation technique, velocity of shortening
Received: April 10, 2003
Accepted April 21, 2003
This study was supported by the National Health and Medical Research Council (grant no. 153809) and the Cooperative Research Centre for Asthma (project 12a).
After bronchoconstriction, deep inspiration (DI) causes dilatation followed by airway re-narrowing. Re-narrowing may be faster in asthmatic than nonasthmatic subjects. This study investigated the relationship between re-narrowing and the magnitude of both DI-induced dilatation and the volume-dependence of respiratory system resistance (Rrs) during tidal breathing.
In 25 asthmatic and 18 nonasthmatic subjects the forced oscillation technique was used to measure Rrs at baseline and after methacholine challenge, during 1 min of tidal breathing, followed by DI to total lung capacity (TLC) and passive return to functional residual capacity (FRC). Dilatation was measured as the decrease in Rrs between end tidal inspiration and TLC, re-narrowing as Rrs at FRC immediately after DI, as per cent Rrs at end-tidal expiration, and volume dependent tidal fluctuation as the difference between mean Rrs at end-expiration and end-inspiration.
Asthmatic subjects had greater re-narrowing, less dilatation, and greater tidal fluctuations both at baseline and after challenge. Re-narrowing correlated with baseline tidal fluctuation and inversely with dilatation. Both baseline tidal fluctuation and dilatation were significant independent predictors of re-narrowing.
Following deep inspiration-induced dilatation, faster airway re-narrowing in asthmatic than nonasthmatic subjects is associated not only with reduced deep inspiration-induced dilatation but also with some property of the airways that is detectable prior to challenge as an increased volume dependence of resistance.
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