Chest
Volume 84, Issue 3, September 1983, Pages 286-294
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Special Communication
Breathing Patterns: 2. Diseased Subjects

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We measured the breathing pattern of normal subjects, asymptomatic smokers, asymptomatic and symptomatic asthmatic patients, and patients with chronic obstructive pulmonary disease, restrictive lung disease, primary pulmonary hypertension and anxiety state utilizing respiratory inductive plethysmography. Respiratory rate was increased above the normal in smokers and in patients with COPD, restrictive lung disease and pulmonary hypertension, but remained normal in asthmatic patients. Inspiratory times (TI) of one second or less often occurred in patients with COPD, restrictive lung disease, and pulmonary hypertension. Smokers and patients with symptomatic asthma, COPD, restrictive lung disease and pulmonary hypertension showed heightened respiratory center drive as reflected by elevated mean inspiratory flow (VT/TI). Fractional inspiratory time was reduced to a variable extent in smokers, symptomatic asthmatic patients and patients with COPD, and was a weak indicator of airways obstruction. Patients with COPD often had major fluctuations of expiratory timing, periodic fluctuations of end-expiratory level, and asynchrony between rib cage and abdominal movements. Chronic anxiety was characterized by frequent sighs; episodic rapid rates alternating with apneas were less common. We conclude that analysis of breathing patterns provides diagnostic discrimination among normal subjects and disease states.

Section snippets

Subjects

The breathing pattern in the supine position was recorded utilizing the respiratory inductive plethysmograph in 47 young and 18 old normal subjects,2 22 cigarette smokers with little or no physiologic evidence of lung disease, 17 asymptomatic asthmatic patients, 15 symptomatic asthmatic patients, 28 patients with chronic obstructive pulmonary disease, 14 patients with restrictive lung disease, seven patients with primary pulmonary hypertension, and 13 patients with the chronic anxiety state (

Normal Subjects

As discussed in a previous article2 differences in age did not affect the mean values of the various breathing pattern components and these data were pooled for comparison with the disease categories (Table 1, 2).

Asymptomatic Smokers

The breathing pattern was monitored in smokers who had abstained from smoking at least three hours prior to testing. Compared to normal subjects, major differences in the breathing pattern were found in the 22 asymptomatic smokers who had little or no pulmonary dysfunction (Table 1).

Smokers

The pattern of breathing was markedly altered in our cigarette smokers who had little or no subjective complaints but often had evidence of small airways disease. VT, f, and V˙min were increased while TI and TI/TTOT were reduced. Although all smokers had abstained from smoking for at least three hours before the study, the increased respiratory center drive as reflected by VT/TI might have been related to carryover effects of nicotine on peripheral chemoreceptors5 or respiratory center6

ACKNOWLEDGMENTS

The authors wish to thank Lee Rickies for preparation of the illustrations.

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    Supported in part by National Heart, Lung and Blood Institute Grant HL-10622 ana a contract from Electric Power Research Institute RP-1373.

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