Thirty month variability of aerosol pulse dispersion and conventional lung function parameters in healthy middle aged smokers and nonsmokers

Abstract

Chronic cigarette consumption is a generally accepted reason for the development of chronic obstructive pulmonary disease (COPD). COPD correlates to histomorphological parameters of lung structure as well as pulmonary function tests (PFT). COPD related changes affect PFT determined by conventional methods (bodyplethysmography, spirometry) as well as parameters of convective gas mixing. This study evaluates the diagnostic potential of a non-invasive aerosol method for the discrimination between healthy smokers and nonsmokers in comparison to conventional PFT. The aerosol method is based on the inhalation of small aerosol pulses suspended in particle free air and determines their changes during the breathing maneuver. Changes of aerosol pulse parameters (APP) are used to describe the convective component of gas mixing during ventilation. PFT and APP were determined in 40 healthy subjects (nonsmoker: 51.1 ± 1.5 years; smoker: 49.6 ± 1.5 years, 39.1 ± 2.2 pack years) before and after a time interval of 30 months. Conventional PFT in smokers and nonsmokers showed no relevant differences between the values at the beginning and the end of the observation period. Thirty months later, at the end of the observation interval, a very similar behavior of the APP was obtained, which strongly confirmed the prior observed differences between smokers and nonsmokers. The data suggest that cigarette smoke-induced variations of lung function are also detectable in clinically asymptomatic smokers. Even in cases of normal PFT, most APP are able to discriminate between healthy smokers and nonsmokers. Since PFT showed only minor differences between both groups, it is indicated that APP are superior to PFT in the detection of early disturbances of lung ventilation in healthy smokers. Mean values of PFT and APP in smokers and nonsmokers showed a high reproducibility of the data obtained at the beginning of the study as well as at the end of the observation period. The data of our study further confirm that parameters of pulmonary gas exchange and gas mixing are affected by cigarette smoke at an earlier time than parameters of breathing mechanics.