Analysis of Forced Wheezes in Asthma Patients

Background: Spirometric parameters can be normal in many stable asthma patients, making a diagnosis difficult at certain times in the course of disease. Objectives: The present study aims to find differences and similarities in the acoustic characteristics of forced wheezes among asthma patients with and without normal spirometric values. Methods: Eleven chronic asthma patients (8 men/3 women) with moderate-to-severe airway obstruction (FEV1 48.4%), 9 stable asthma patients (6 males/3females) with normal spirometry (FEV1 84.0%) and a positive methacholine test and 14 healthy subjects (8/6) were enrolled in the study. A contact sensor was placed on the trachea, and wheezes were detected by a modified Shabtai-Musih algorithm in a time-frequency representation. Results: More wheezes were recorded in obstructive asthma patients than in stable asthma and control subjects: nonstable asthma 13.6 (13.3), stable asthma 3.5 (3.0) and control subjects 2.5 (2.1). The mean frequency of all wheezes detected was higher in control subjects than in either stable or non-stable asthma patients. The change in the total number of wheezes after terbutaline inhalation was more pronounced in nonstable asthma patients than in stable asthmatics and control subjects. Conclusions: This study confirms that wheeze recording during forced expiratory maneuvers can be a complementary measure to spirometry to identify asthma patients.

[1]  Buist As.  Standardization of spirometry. , 1987 .

[2]  J B Grotberg,et al.  Spectral content of forced expiratory wheezes during air, He, and SF6 breathing in normal humans. , 1992, Journal of applied physiology.

[3]  Raimon Jané,et al.  Detection of wheezing during maximal forced exhalation in patients with obstructed airways. , 2002, Chest.

[4]  G. Charbonneau,et al.  Forced expirations in normal subjects. Is the shape of the flow rate curve related to existence of a wheeze? , 1987, Chest.

[5]  P Caminal,et al.  Analysis of tracheal sounds during forced exhalation in asthma patients and normal subjects: bronchodilator response effect. , 1999, Chest.

[6]  Alfred O. Berg,et al.  Clinical Guidelines And Primary Care Guidelines For The Diagnosis And Management Of Asthma , 2012 .

[7]  J B Grotberg,et al.  Forced expiratory wheezes are a manifestation of airway flow limitation. , 1987, Journal of applied physiology.

[8]  B. Thompson,et al.  Wheezing on maximal forced exhalation in the diagnosis of atypical asthma. Lack of sensitivity and specificity. , 2020, Annals of Internal Medicine.

[9]  B M Cheetham,et al.  The relationship between wheezing and lung mechanics during methacholine-induced bronchoconstriction in asthmatic subjects. , 1996, American journal of respiratory and critical care medicine.

[10]  J Vanderschoot,et al.  Lung sounds during allergen-induced asthmatic responses in patients with asthma. , 1996, American journal of respiratory and critical care medicine.

[11]  King Dk,et al.  Wheezing on maximal forced exhalation in the diagnosis of atypical asthma. Lack of sensitivity and specificity. , 1989 .

[12]  R. Pauwels,et al.  GLOBAL STRATEGY FOR ASTHMA MANAGEMENT AND PREVENTION , 1996 .

[13]  J J Marini,et al.  The significance of wheezing in chronic airflow obstruction. , 1979, The American review of respiratory disease.

[14]  G. Schultze-Werninghaus,et al.  Forced Expiratory Wheezes in a Patientwith Dynamic Expiratory Narrowing ofCentral Airways and an Oscillating Patternof the Flow-Volume Curve , 1999, Respiration.

[15]  S. Kraman,et al.  The forced expiratory wheeze. Its site of origin and possible association with lung compliance. , 1983, Respiration; international review of thoracic diseases.

[16]  Steve S. Kraman,et al.  The Forced Expiratory Wheeze , 1983 .

[17]  Antoni Homs-Corbera,et al.  Time-frequency detection and analysis of wheezes during forced exhalation , 2004, IEEE Transactions on Biomedical Engineering.

[18]  Airway behavior and its regulation: how do structural changes affect airway behavior? , 1996, American journal of respiratory and critical care medicine.

[19]  J Vanderschoot,et al.  Abnormal lung sounds in patients with asthma during episodes with normal lung function. , 1994, Chest.

[20]  D. Navajas,et al.  Spirometric reference values from a Mediterranean population. , 1986, Bulletin europeen de physiopathologie respiratoire.