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Can DLNO/DLCO ratio offset prejudicial effects of functional heterogeneities in acinar regions?
Respiratory Physiology & Neurobiology ( IF 1.9 ) Pub Date : 2020-08-14 , DOI: 10.1016/j.resp.2020.103517
Kazuhiro Yamaguchi 1 , Takao Tsuji 1 , Kazutetsu Aoshiba 2 , Hiroyuki Nakamura 2 , Shinji Abe 1
Affiliation  

Objectives

(1) To establish the general equation that describes relationship of DMCO/Vc versus DLNO/DLCO under conditions with no functional heterogeneities. (2) To examine the effects of functional heterogeneities, including parallel and series (stratified) heterogeneities, on DLNO/DLCO.

Results and discussions: (1) Given that “true” θNO in pulmonary capillaries is represented by surface absorption-related θNO, relationship between DMCO/Vc and DLNO/DLCO does not differ significantly from that obtained on premise of infinite θNO. DLNO/DLCO decided physiologically may mirror morphometric DMCO/Vc actually working for gas exchange but not “total” morphometric ratio of DMCO/Vc. (2) There are three parallel heterogeneities that affect diffusing capacity (D)-related parameters. Of them, only the heterogeneity of D/VA, where VA is alveolar volume, underestimates DLCO and DLNO. DLNO/DLCO does not alleviate negative impact of D/VA heterogeneity, indicating that DMCO/Vc estimated from DLNO/DLCO does not mirror “true” morphometric DMCO/Vc in diseased lungs with D/VA maldistribution. (3) Stratified heterogeneity underrates morphometric DMCO, DMNO, and DMNO/DMCO maximally by 1.4 %, 2.8 %, and 1.4 %, respectively, under conditions similar to single-breath D measurements, suggesting that effect of stratified heterogeneity on D measures is no longer needed to be considered in normal subjects but may be in patients having lung diseases with destructive lesions of acinar structures.



中文翻译:

DLNO/DLCO 比率能否抵消腺泡区功能异质性的不利影响?

目标

(1) 建立描述无功能异质性条件下DM CO /VcDL NO /DL CO关系的一般方程。(2) 检查功能异质性,包括平行和系列(分层)异质性,对 DL NO / DL CO 的影响

结果与讨论: (1) 考虑到肺毛细血管中“真实”θ NO由表面吸收相关的θ NO 表示,DM CO /Vc 与DL NO /DL CO之间的关系与在无限大的前提下获得的关系没有显着差异θ。生理学上决定的DL NO / DL CO可能反映实际用于气体交换的形态计量 DM CO /Vc,但不是 DM CO /Vc 的“总”形态计量比。(2) 存在影响扩散能力 (D) 相关参数的三个平行异质性。其中,只有 D/V A的异质性,其中 V A是肺泡体积,低估了 DL CO和 DL NO。DL NO /DL CO不会减轻 D/V A异质性的负面影响,表明从 DL NO /DL CO估计的DM CO /Vc不能反映D/V A 分布不均的患病肺中的“真实”形态计量 DM CO /Vc . (3) 分层异质性低估了形态计量 DM CO、DM NO和 DM NO /DM CO 在类似于单次呼吸 D 测量的条件下,最大分别为 1.4 %、2.8 % 和 1.4 %,这表明在正常受试者中不再需要考虑分层异质性对 D 测量的影响,但可能在患有肺的患者中具有腺泡结构破坏性病变的疾病。

更新日期:2020-08-21
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