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Estimating Airway Resistance from Forced Expiration in Spirometry

1
Laboratory for Respiratory Diseases, Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, 3000 Leuven, Belgium
2
Measure, Model & Manage Bioresponses (M3-BIORES), Division Animal and Human Health Engineering, Department of Biosystems, KU Leuven, 3000 Leuven, Belgium
*
Author to whom correspondence should be addressed.
Appl. Sci. 2019, 9(14), 2842; https://doi.org/10.3390/app9142842
Received: 6 June 2019 / Revised: 2 July 2019 / Accepted: 11 July 2019 / Published: 16 July 2019
(This article belongs to the Special Issue Human Health Engineering)
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Abstract

Spirometry is the gold standard to detect airflow limitation, but it does not measure airway resistance, which is one of the physiological factors behind airflow limitation. In this study, we describe the dynamics of forced expiration in spirometry using a deflating balloon and using this model. We propose a methodology to estimate ζ (zeta), a dimensionless and effort-independent parameter quantifying airway resistance. In N = 462 (65 ± 8 years), we showed that ζ is significantly (p < 0.0001) greater in COPD (2.59 ± 0.99) than healthy smokers (1.64 ± 0.18), it increased significantly (p < 0.0001) with the severity of airflow limitation and it correlated significantly (p < 0.0001) with airway resistance (r = 0.55) and specific conductance (r = −0.60) obtained from body-plethysmography. ζ also showed significant associations (p < 0.001) with diffusion capacity (r = −0.64), air-trapping (r = 0.68), and CT densitometry of emphysema (r = 0.40 against % below −950 HU and r = −0.34 against 15th percentile HU). Moreover, simulation studies demonstrated that an increase in ζ resulted in lower airflows from baseline. Therefore, we conclude that ζ quantifies airway resistance from forced expiration in spirometry—a method that is more abundantly available in primary care than traditional but expensive methods of measuring airway resistance such as body-plethysmography and forced oscillation technique. View Full-Text
Keywords: spirometry; airflow limitation; airway resistance; specific airway conductance; COPD; body-plethysmography; forced expiration; alveolar pressure; emphysema; computed tomography; air-trapping spirometry; airflow limitation; airway resistance; specific airway conductance; COPD; body-plethysmography; forced expiration; alveolar pressure; emphysema; computed tomography; air-trapping
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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MDPI and ACS Style

Das, N.; Verstraete, K.; Topalovic, M.; Aerts, J.-M.; Janssens, W. Estimating Airway Resistance from Forced Expiration in Spirometry. Appl. Sci. 2019, 9, 2842.

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