ArticleBMC pulmonary medicine2025
Impulse oscillometry for the detection of small airway dysfunction in patients with chronic respiratory symptoms, preserved ratio impaired spirometry and COPD.
Article in BMC pulmonary medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Small Airway Disease in Pre-COPD and Early COPD: Insights Into the Pulmonary "Silent Zone".International journal of chronic obstructive pulmonary disease · 2026Review
- Small airway dysfunction: a shared, early, measurable, and potentially treatable trait across COPD, asthma, and fibrotic lung disease.Frontiers in medicine · 2026Review
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5 authors.
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Abstract
backgroundPersistent chronic airway inflammation and progressive airflow limitation are typical features of chronic obstructive pulmonary disease (COPD). Emerging evidence indicates that small airway dysfunction (SAD) plays a critical role in driving the sustained pathological progression of COPD. Preserved ratio impaired spirometry (PRISm) represents a spirometric pattern characterized by a reduced forced expiratory volume in 1 second (FEV₁) despite a preserved ratio. Current evidence inadequately elucidates the pathophysiological role of SAD and its intricate interplay with PRISm and COPD progression. On the other hand, impulse oscillometry (IOS) can be used as a complementary tool to spirometry to detect SAD. Detection of SAD in patients with chronic respiratory symptoms could help in the diagnosis of PRISm and COPD when spirometry is not achievable.
objectiveTo investigate the diagnostic value of IOS for identifying SAD in patients with chronic respiratory symptoms, PRISm and COPD.
methodsBetween September 2021 and July 2023, 552 symptomatic patients without known structural lung disease who underwent both spirometry and IOS on the same day in the outpatient clinic were evaluated. The correlations between spirometry and the IOS parameters, and the ROC curves of the IOS parameters for SAD patients and COPD patients were analyzed.
resultsAmong the 552 patients included in the study, 96 patients had COPD, 39 patients had PRISm, and 417 patients had chronic cough. Among 456 chronic cough patients with preserved ratio spirometry, the incidence of PRISm was 8.55%. Based on spirometry-defined SAD, the incidence of SAD in the PRISm population was 71.8%, which was significantly higher than the 9.35% of the non-PRISm population. With increasing COPD GOLD stage, the IOS parameters R5-R20, R5, Fres, and Ax increased, whereas the traditional lung function parameters and X5 decreased. R5-R20, X5, Fres, and AX of COPD GOLD stage 1 patients were not substantially different from those of PRISm patients. In PRISm patients, R5-R20, R5 and Fres were strongly correlated with FEF
conclusionAlmost all IOS parameters Linked to the small airways were significantly different in the PRISm population compared with patients with chronic respiratory symptoms. SAD severity in PRISm patients is similar to that in GOLD stage 2 COPD patients. The IOS can assess the disease severity of COPD.
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