Allergy Asthma Immunol Res.  2013 Sep;5(5):322-328. 10.4168/aair.2013.5.5.322.

Usefulness of Colored 3D Imaging of Respiratory Impedance in Asthma

• Shirai T
• Mori K
• Mikamo M
• Shishido Y
• Akita T
• Morita S
• Asada K
• Fujii M
• Suda T
• Chida K

• KMID: 2260814
• DOI: http://doi.org/10.4168/aair.2013.5.5.322

Abstract

PURPOSE
Recently, the clinical application of the forced oscillation technique (FOT) has progressed with the spread of commercially available FOT devices, including the impulse oscillation system and MostGraph. We investigated the usefulness of color 3D imaging of respiratory impedance in asthma using MostGraph.
METHODS
Whole-breath and within-breath respiratory system resistance (Rrs) and reactance (Xrs) were measured in 78 patients with asthma. Color 3D images were classified into three patterns: the chronic obstructive pulmonary disease (COPD)-like pattern (high values of Rrs and Xrs with a marked respiratory cycle and frequency dependence), the asthma pattern (moderately high Rrs over the entire frequency and a respiratory cycle with slight Xrs changes), and a normal-like pattern (low Rrs and Xrs with few within-breath changes). The classification was performed by three researchers, who were unaware of the clinical information, and the clinical characteristics were compared among the three groups.
RESULTS
Color 3D imaging provided a COPD-like pattern in 25 patients, an asthma pattern in 39 patients, and a normal-like pattern in 14 patients. Patients with the COPD-like pattern were predominantly female with a higher body mass index, lower forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), and higher Rrs and Xrs values (whole-breath and within-breath variation). Those with the normal pattern had higher FEV1 and FVC, and a lower single-breath nitrogen washout slope. There were no differences in asthma control or exhaled nitric oxide levels among the three groups.
CONCLUSIONS
These results suggest that color 3D imaging of respiratory impedance may show asthma phenotypes.

Keyword

Forced oscillation technique; multi-frequency; phenotype; whole-breath; within-breath

MeSH Terms

Asthma
Body Mass Index
Electric Impedance
Female
Forced Expiratory Volume
Humans
Nitric Oxide
Nitrogen
Phenotype
Pulmonary Disease, Chronic Obstructive
Respiratory System
Vital Capacity
Nitric Oxide
Nitrogen

Figure

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  Fig. 1 Color 3D imaging of respiratory impedance in each representative subject. High values of Rrs and Xrs with a marked respiratory cycle and frequency dependence, moderately high Rrs over the entire frequency and a respiratory cycle with slight Xrs changes, and low Rrs and Xrs with few within-breath changes were found in a patient with COPD, a patient with asthma, and a normal control subject, respectively.

• 

  Fig. 2 Color 3D imaging patterns of respiratory impedance in patients with asthma. Color 3D images were classified visually into COPD-like, asthma, and normal-like patterns by three researchers who were unaware of the clinical information and classified images by a majority decision when necessary. The COPD-like pattern corresponded to the pattern usually found in patients with COPD, while the normal-like pattern corresponded to the pattern usually found in normal controls.

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