Regional pulmonary perfusion, inflation, and ventilation defects in bronchoconstricted patients with asthma

R. Scott Harris; Tilo Winkler; Nora Tgavalekos; Guido Musch; Marcos F. Vidal Melo; Tobias Schroeder; Yuchiao Chang; José G. Venegas

doi:10.1164/rccm.200510-1634OC

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Regional pulmonary perfusion, inflation, and ventilation defects in bronchoconstricted patients with asthma

Journal article

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Regional pulmonary perfusion, inflation, and ventilation defects in bronchoconstricted patients with asthma

R. Scott Harris, Tilo Winkler, Nora Tgavalekos, Guido Musch, Marcos F. Vidal Melo, Tobias Schroeder, Yuchiao Chang and José G. Venegas

American journal of respiratory and critical care medicine, Vol.174(3), pp.245-253

08/01/2006

DOI: 10.1164/rccm.200510-1634OC

PMCID: PMC2648114

PMID: 16690973

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https://www.ncbi.nlm.nih.gov/pmc/articles/2648114View

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Abstract

Rationale: Bronchoconstriction in asthma leads to heterogeneous ventilation and the formation of large and contiguous ventilation defects in the lungs. However, the regional adaptations of pulmonary perfusion (Q̇) to such ventilation defects have not been well studied. Methods: We used positron emission tomography to assess the intrapulmonary kinetics of intravenously infused tracer nitrogen-13 (13NN), and measured the regional distributions of ventilation and perfusion in 11 patients with mild asthma. For each subject, the regional washout kinetics of 13NN before and during methacholine-induced bronchoconstriction were analyzed. Two regions of interest (ROIs) were defined: one over a spatially contiguous area of high tracer retention (TR) during bronchoconstriction and a second one covering an area of similar size, showing minimal tracer retention (NR). Results: Both ROIs demonstrated heterogeneous washout kinetics, which could be described by a two-compartment model with fast and slow washout rates. We found a systematic reduction in regional Q̇ to the TR ROI during bronchoconstriction and a variable and nonsignificant change in relative Q̇ for NR regions. The reduction in regional Q̇ was associated with an increase in regional gas content of the TR ROI, but its magnitude was greater than that anticipated solely by the change in regional lung inflation. Conclusion: During methacholine-induced bronchoconstriction, perfusion to ventilation defects are systematically reduced by a relative increase in regional pulmonary vascular resistance.

Emission computed tomography

Pulmonary gas exchange

Vascular resistance

Vasoconstriction

Ventilation-perfusion ratio

Details

Title: Subtitle: Regional pulmonary perfusion, inflation, and ventilation defects in bronchoconstricted patients with asthma
Creators: R. Scott Harris - Harvard University
Tilo Winkler - Massachusetts General Hospital
Nora Tgavalekos - Massachusetts General Hospital
Guido Musch - Harvard University
Marcos F. Vidal Melo
Tobias Schroeder - Boston University
Yuchiao Chang - Harvard University
José G. Venegas - Harvard University
Resource Type: Journal article
Publication Details: American journal of respiratory and critical care medicine, Vol.174(3), pp.245-253
DOI: 10.1164/rccm.200510-1634OC
PMID: 16690973
PMCID: PMC2648114
NLM abbreviation: Am J Respir Crit Care Med
ISSN: 1073-449X
eISSN: 1073-449X
Number of pages: 9
Grant note: K08HL004501 / National Heart, Lung, and Blood Institute (http://data.elsevier.com/vocabulary/SciValFunders/100000050)
Language: English
Date published: 08/01/2006
Academic Unit: Anesthesia
Record Identifier: 9985141863502771

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