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. 1982 Jul;37(7):516–520. doi: 10.1136/thx.37.7.516

Effects of acute and long-term bronchodilator treatment on regional lung function in asthma assessed with krypton-81m and technetium-99m-labelled macroaggregates.

A R Sovijärvi, L Pöyhönen, L Kellomäki, A Muittari
PMCID: PMC459358  PMID: 6215738

Abstract

We have investigated the effect of acute and long-term bronchodilator treatment on the distribution of ventilation and perfusion in 15 asthmatics using a gamma camera, krypton-81m (for ventilation) and technetium-99m macroaggregate (for perfusion). Individual peak expiratory flow (PEF) values before bronchodilation were slightly or moderately below the predicted values. The simultaneous ventilation images (analysed visually) showed areas of delayed ventilation in all patients (mean distribution score on 3-point scale 2.1). After isoprenaline inhalation (240 micrograms) the mean PEF increased by 24%, but the distribution of ventilation remained virtually unchanged in all patients (mean score 2.0). Simultaneously defects in perfusion could be seen in all patients (mean score 1.5). After intensive treatment, when the mean PEF increased by a further 29%, the distribution scores of ventilation and perfusion fell to 0.8 and 0.9, respectively. The results indicate that, without intensive and long-term treatment, appreciable inequality of ventilation and perfusion are usual consequences of asthma; and suggest that although larger airways are dilated by isoprenaline inhalations residual bronchial obstruction may still remain in some smaller airways, maintaining uneven distribution. Perfusion disturbances seem to be secondary to changes in regional ventilation.

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Selected References

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  1. BENTIVOGLIO L. G., BEEREL F., BRYAN A. C., STEWART P. B., ROSE B., BATES D. V. REGIONAL PULMONARY FUNCTION STUDIED WITH XENON IN PATIENTS WITH BRONCHIAL ASTHMA. J Clin Invest. 1963 Aug;42:1193–1200. doi: 10.1172/JCI104805. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. COURNAND A. Pulmonary circulation; its control in man, with some remarks or methodology. Science. 1957 Jun 21;125(3260):1231–1235. doi: 10.1126/science.125.3260.1231. [DOI] [PubMed] [Google Scholar]
  3. Chick T. W., Nicholson D. P., Johnson R. L., Jr Effects of isoproterenol on distribution of ventilation and perfusion in asthma. Am Rev Respir Dis. 1973 May;107(5):869–873. doi: 10.1164/arrd.1973.107.5.869. [DOI] [PubMed] [Google Scholar]
  4. Fazio F., Jones T. Assessment of regional ventilation by continuous inhalation of radioactive krypton-81m. Br Med J. 1975 Sep 20;3(5985):673–676. doi: 10.1136/bmj.3.5985.673. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Fazio F., Lavender J. P., Steiner R. E. 81mKr ventilation and 99mTc perfusion scans in chest disease: comparison with standard radiographs. AJR Am J Roentgenol. 1978 Mar;130(3):421–428. doi: 10.2214/ajr.130.3.421. [DOI] [PubMed] [Google Scholar]
  6. Fazio F., Palla A., Santolicandro A., Solfanelli S., Fornai E., Giuntini C. Studies of regional ventilation in asthma using 81mKr. Lung. 1979;156(3):185–194. doi: 10.1007/BF02714009. [DOI] [PubMed] [Google Scholar]
  7. Gregg I., Nunn A. J. Peak expiratory flow in normal subjects. Br Med J. 1973 Aug 4;3(5874):282–284. doi: 10.1136/bmj.3.5874.282. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Heckscher T., Bass H., Oriol A., Rose B., Anthoniesen N. R., Bates D. V. Regional lung function in patients with bronchial asthma. J Clin Invest. 1968 May;47(5):1063–1070. doi: 10.1172/JCI105796. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Knudson R. J., Constantine H. P. An effect of isoproterenol on ventilation-perfusion in asthmatic versus normal subjects. J Appl Physiol. 1967 Mar;22(3):402–406. doi: 10.1152/jappl.1967.22.3.402. [DOI] [PubMed] [Google Scholar]
  10. Lavender J. P., Cunningham D. A. Clinical value of krypton-81m and technetium-99m perfusion lung scanning. Bull Eur Physiopathol Respir. 1980 May-Jun;16(3):309–320. [PubMed] [Google Scholar]
  11. RAHN H., BAHNSON H. T. Effect of unilateral hypoxia on gas exchange and calculated pulmonary blood flow in each lung. J Appl Physiol. 1953 Aug;6(2):105–112. doi: 10.1152/jappl.1953.6.2.105. [DOI] [PubMed] [Google Scholar]
  12. Reyes A., Sykes M. K., Chakrabarti M. K., Tait A., Petrie A. The effect of salbutamol on hypoxic pulmonary vasoconstriction in dogs. Bull Eur Physiopathol Respir. 1978 Nov-Dec;14(6):741–753. [PubMed] [Google Scholar]
  13. Schor R. A., Shames D. M., Weber P. M., Dos Remedios L. V. Regional ventilation studies with Kr-81m and Xe-133: a comparative analysis. J Nucl Med. 1978 Apr;19(4):348–353. [PubMed] [Google Scholar]
  14. TAUBER K., KEYSSLER H., PARHOFER R. Uber die Blutverteilung in der Lunge bei mangelhafter Sauerstoffversorgung eines Lappens. Munch Med Wochenschr. 1958 Jul 25;100(30):1106–1107. [PubMed] [Google Scholar]
  15. Taplin G. V., Tashkin D. P., Chopra S. K., Anselmi O. E., Elam D., Calvarese B., Coulson A., Detels R., Rokaw S. N. Early detection of chronic obstructive pulmonary disease using radionuclide lung-imaging procedures. Chest. 1977 May;71(5):567–575. doi: 10.1378/chest.71.5.567. [DOI] [PubMed] [Google Scholar]
  16. Wilson A. F., Surprenant E. L., Beall G. N., Siegel S. C., Simmons D. H., Bennett L. R. The significance of regional pulmonary function changes in bronchial asthma. Am J Med. 1970 Apr;48(4):416–423. doi: 10.1016/0002-9343(70)90040-9. [DOI] [PubMed] [Google Scholar]

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