Abstract
In acute dyspnea differentiating between COPD exacerbations and acute heart failure represents an important clinical issue. Nowadays there are no accurate methods to discriminate the two diseases. Our hypothesis is that FOT allows to identify the different mechanical properties of both conditions.
During the first day of hospitalization each patient underwent two FOT measurements in multifrequency (5-11-19 MHz) for two minutes at tidal volume in a sitting position. Three groups were evaluated: 11 patients with AECOPD (age 69±8 years, mean±SD, BMI 24,5±2,7 kg/m², FEV1 35±17% predicted); 11 patients with AHF, NYHA IV class (age 75±1, BMI 29,4 ± 8,1 kg/m²) and 6 healthy non-smoker subjects (mean age 63±3, BMI 27,7±5,0 kg/m², normal spirometry).
All 28 subjects executed FOT with adequate compliance. 5-Hz resistance and reactance, 11 and 19-Hz reactance values were significantly increased in AECOPD compared to the other two groups (P<0,05). 11 and 19-Hz resistance values did not show significant differences between the three groups. Expiratory flow limitation (ΔXrs >2,81 cmH2O*s*L-1) distinguished AECOPD from the other two groups (P<0,05).
FOT may permit accurate discrimination of AECOPD from AHF in hospitalized subjects with acute dyspnea, and should therefore be confirmed on a larger scale.
- Copyright ©ERS 2015
