Abstract
BackgroundRegional lung sound intensity in chronic obstructive pulmonary disease (COPD) patients is influenced by the severity and distribution of emphysema, obstructed peripheral airways, and altered ribcage and diaphragm configurations and movements due to hyperinflation. Changes in the lung sound distribution accompanied by pulmonary function improvements in COPD patients were observed after bronchodilator inhalation. We investigated the association of lung sound distribution with pulmonary functions, and the effects of emphysematous lesions on this association. These studies were designed to acquire the basic knowledge necessary for the application of lung sound analysis in the physiological evaluation of COPD patients.MethodsPulmonary function tests and the percentage of upper- and lower-lung sound intensity (quantitative lung data [QLD]) were evaluated in 47 stable male COPD patients (54 - 82 years of age). In 39 patients, computed tomography taken within 6 months of the study was available and analyzed.ResultsThe ratio of lower QLD to upper QLD showed significant positive correlations with FEV1 %predicted (%FEV1; ρ = 0.45, p<0.005) and MEF50 %predicted (%MEF50; ρ = 0.46, p<0.005). These correlations were not observed in COPD patients with dominant emphysema (% low attenuation area >40%, n = 20) and were stronger in less emphysematous patients (n = 19, %FEV1; ρ = 0.64, p<0.005, %MEF50; ρ = 0.71, p<0.001).ConclusionsIn COPD patients, the ratio of lower- to upper-lung sound intensities decreased according to the severity of obstructive changes, although emphysematous lesions considerably affected lung sound distribution.
Highlights
Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow limitation
We investigated the association of lung sound distribution with pulmonary function in chronic obstructive pulmonary disease (COPD) patients and healthy subjects, with the goal of acquiring basic knowledge regarding the association of lung sound distribution with pulmonary function
Between April 2007 and March 2013, acceptable VRI recording data were obtained for 47 COPD patients
Summary
Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow limitation. In severe COPD patients, the movements of the diaphragm are restricted, and accessory respiratory muscles, such as sternocleidomastoid and scalene muscles, are recruited during tidal breathing [4,5] In these circumstances, it seems that regional ventilation may shift from the lower- to upper-lung field, according to the degree of hyperinflation. Regional lung sound intensity in chronic obstructive pulmonary disease (COPD) patients is influenced by the severity and distribution of emphysema, obstructed peripheral airways, and altered ribcage and diaphragm configurations and movements due to hyperinflation. We investigated the association of lung sound distribution with pulmonary functions, and the effects of emphysematous lesions on this association These studies were designed to acquire the basic knowledge necessary for the application of lung sound analysis in the physiological evaluation of COPD patients
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