School of Mechanical Engineering, Kyungpook National University, Daegu, South Korea.
Division of Respiratory Medicine and Allergy, Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea.
Physiol Rep. 2024 Jan;12(1):e15909. doi: 10.14814/phy2.15909.
Asthma with fixed airway obstruction (FAO) is associated with significant morbidity and rapid decline in lung function, making its treatment challenging. Quantitative computed tomography (QCT) along with data postprocessing is a useful tool to obtain detailed information on airway structure, parenchymal function, and computational flow features. In this study, we aim to identify the structural and functional differences between asthma with and without FAO. The FAO group was defined by a ratio of forced expiratory volume in 1 s (FEV ) to forced vital capacity (FVC), FEV /FVC <0.7. Accordingly, we obtained two sets of QCT images at inspiration and expiration of asthma subjects without (N = 24) and with FAO (N = 12). Structural and functional QCT-derived airway variables were extracted, including normalized hydraulic diameter, normalized airway wall thickness, functional small airway disease, and emphysema percentage. A one-dimensional (1D) computational fluid dynamics (CFD) model considering airway deformation was used to compare the pressure distribution between the two groups. The computational pressures showed strong correlations with the pulmonary function test (PFT)-based metrics. In conclusion, asthma participants with FAO had worse lung functions and higher-pressure drops than those without FAO.
固定气道阻塞(FAO)的哮喘与显著的发病率和肺功能快速下降有关,使其治疗具有挑战性。定量计算机断层扫描(QCT)结合数据后处理是一种获取气道结构、实质功能和计算流动特征详细信息的有用工具。在这项研究中,我们旨在确定有和没有 FAO 的哮喘之间的结构和功能差异。FAO 组的定义是 1 秒用力呼气量(FEV )与用力肺活量(FVC)的比值,FEV/FVC<0.7。因此,我们在没有(N=24)和有 FAO(N=12)的哮喘患者的吸气和呼气时获得了两组 QCT 图像。提取了结构和功能 QCT 衍生的气道变量,包括归一化水力直径、归一化气道壁厚度、功能性小气道疾病和肺气肿百分比。考虑到气道变形的一维(1D)计算流体动力学(CFD)模型用于比较两组之间的压力分布。计算压力与基于肺功能测试(PFT)的指标具有很强的相关性。总之,有 FAO 的哮喘患者的肺功能比没有 FAO 的患者更差,压力降更高。