Journal article
The lognormal lung: A new approach to quantifying lung inhomogeneity in COPD
- Abstract:
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Early diagnosis and disease phenotyping in COPD are currently limited by the use of spirometry, which may remain normal despite significant small-airways disease and which may not fully capture a patient’s underlying pathophysiology. In this study we explored the use of a new non-invasive technique that assesses gas-exchange inhomogeneity in patients with COPD of varying disease severity (according to GOLD Stage), compared with age-matched healthy controls. The technique, which combines highly accurate measurement of respiratory gas exchange using a bespoke molecular flow sensor and a mechanistic mathematical model of the lung, provides new indices of lung function: the parameters σCL, σCd, and σVD represent the standard deviations of distributions for alveolar compliance, anatomical deadspace and vascular conductance relative to lung volume, respectively. It also provides parameter estimates for total anatomical deadspace and functional residual capacity (FRC). We demonstrate that these parameters are robust and sensitive, and that they can distinguish between healthy individuals and those with mild-moderate COPD (stage 1–2), as well as distinguish between mild-moderate COPD (stage 1–2) and more severe (stage 3–4) COPD. In particular, σCL, a measure of unevenness in lung inflation/deflation, could represent a more sensitive non-invasive marker of early or mild COPD. In addition, by providing a multi-dimensional assessment of lung physiology, this technique may also give insight into the underlying pathophysiological phenotype for individual patients. These preliminary results warrant further investigation in larger clinical research studies, including interventional trials.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 1.1MB, Terms of use)
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- Publisher copy:
- 10.3389/fphys.2022.1032126
Authors
- Publisher:
- Frontiers Media
- Journal:
- Frontiers in Physiology More from this journal
- Volume:
- 13
- Article number:
- 1032126
- Publication date:
- 2022-10-31
- Acceptance date:
- 2022-10-11
- DOI:
- EISSN:
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1664-042X
- ISSN:
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1664-042X
- Language:
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English
- Keywords:
- Pubs id:
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1301513
- Local pid:
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pubs:1301513
- Deposit date:
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2022-11-11
- ARK identifier:
Terms of use
- Copyright holder:
- Smith et al.
- Copyright date:
- 2022
- Rights statement:
- © 2022 Smith, Magor-Elliott, Fullerton, Couper, Richmond, Hancock, Ritchie, Robbins, Talbot and Petousi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
- Licence:
- CC Attribution (CC BY)
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