Cristina García-Quero1, José Carreras1, Elisabet Martínez-Cerón2, Raquel Casitas2, Raúl Galera2, Cristina Utrilla3, Isabel Torres3, Francisco García-Río4. 1. Servicio de Neumología, Hospital Universitario La Paz-Carlos III, IdiPAZ, Madrid, España. 2. Servicio de Neumología, Hospital Universitario La Paz-Carlos III, IdiPAZ, Madrid, España; Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Madrid, España. 3. Servicio de Radiodiagnóstico, Hospital Universitario La Paz, Madrid, España. 4. Servicio de Neumología, Hospital Universitario La Paz-Carlos III, IdiPAZ, Madrid, España; Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Madrid, España; Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, España. Electronic address: fgr01m@gmail.com.
Abstract
INTRODUCTION: Small airway dysfunction (SAD) caused by smoking contributes to the early onset of airflow limitation (AFL), although its impact on patients' perception of health is largely unknown. We aimed to evaluate the frequency of SAD in active smokers without AFL, and to compare health-related quality of life (HRQoL) of non-smokers, smokers without SAD, smokers with SAD, and smokers with AFL. METHODS: A total of 53 active smokers without AFL, 20 smokers with AFL, and 20 non-smokers completed the SF-36 and EuroQoL questionnaires and performed impulse oscillometry and spirometry. Pulmonary parenchymal attenuation was determined in inspiration and expiration. SAD was determined to exist when resistance at 5Hz (R5), the difference between R5 and R20, and reactance area (AX) exceeded the upper limit of normal. RESULTS: In total, 35.8% of smokers without AFL had SAD. No differences were detected in spirometric parameters or pulmonary attenuation between smokers with or without AFL and non-smokers. However, smokers with SAD had worse scores on HRQoL questionnaires than smokers without SAD or non-smokers, and scores compared to smokers with AFL were intermediate. R5 and X5 were identified as independent determinants of HRQoL in smokers without AFL. CONCLUSIONS: SAD is common in smokers without AFL, affecting one third of this population, and independently affecting their perception of health.
INTRODUCTION: Small airway dysfunction (SAD) caused by smoking contributes to the early onset of airflow limitation (AFL), although its impact on patients' perception of health is largely unknown. We aimed to evaluate the frequency of SAD in active smokers without AFL, and to compare health-related quality of life (HRQoL) of non-smokers, smokers without SAD, smokers with SAD, and smokers with AFL. METHODS: A total of 53 active smokers without AFL, 20 smokers with AFL, and 20 non-smokers completed the SF-36 and EuroQoL questionnaires and performed impulse oscillometry and spirometry. Pulmonary parenchymal attenuation was determined in inspiration and expiration. SAD was determined to exist when resistance at 5Hz (R5), the difference between R5 and R20, and reactance area (AX) exceeded the upper limit of normal. RESULTS: In total, 35.8% of smokers without AFL had SAD. No differences were detected in spirometric parameters or pulmonary attenuation between smokers with or without AFL and non-smokers. However, smokers with SAD had worse scores on HRQoL questionnaires than smokers without SAD or non-smokers, and scores compared to smokers with AFL were intermediate. R5 and X5 were identified as independent determinants of HRQoL in smokers without AFL. CONCLUSIONS:SAD is common in smokers without AFL, affecting one third of this population, and independently affecting their perception of health.
Authors: Wei Chen; David R Janz; Ciara M Shaver; Gordon R Bernard; Julie A Bastarache; Lorraine B Ware Journal: Chest Date: 2015-12 Impact factor: 9.410