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Fouzas S, Kogias C, Gioulvanidou M, Bertzouanis A, Chrysochoou EA, Anthracopoulos MΒ, Tsanakas J, Hatziagorou E. Low-frequency oscillometry indices to assess ventilation inhomogeneity in CF patients. Pediatr Pulmonol 2023; 58:3147-3155. [PMID: 37555768 DOI: 10.1002/ppul.26635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 07/21/2023] [Accepted: 07/29/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND The utility of the forced oscillations technique (FOT) in cystic fibrosis (CF) remains uncertain. The aim of this study was to explore the ability of lower-frequency FOT indices, alone and after adjustment for the lung volume, to assess the extent of ventilation inhomogeneity in CF patients with varying disease severity. METHODS Forty-five children, adolescents, and adults with CF (age 6.9-27 years) underwent spirometry, FOT, and nitrogen multiple-breath washout (N2-MBW) measurements. The respiratory resistance and reactance at 5 Hz (Rrs5 and Xrs5, respectively) were recorded, and a novel FOT index, the specific respiratory conductance (sGrs), was computed as the reciprocal of Rrs5 divided by the functional residual capacity. RESULTS The sGrs correlated well with the lung clearance index (LCI) (Spearman's r: -.797), whereas the correlation of Rrs5 and Xrs5 with the LCI, albeit significant, was weaker (r: .643 and -.631, respectively). The sGrs emerged as the most robust predictor of LCI regardless of the severity of lung disease, as reflected by patients' age and lung function measurements. Most importantly, the relationship between sGrs and LCI remained unaffected by lung hyperinflation, as opposed to that of the LCI with the spirometric and standard FOT indices. CONCLUSIONS In CF patients, the FOT indices at 5 Hz and the novel, volume-adjusted parameter sGrs, reflect the extent of lung involvement and the underlying ventilation inhomogeneity in a way comparable to N2-MBW. Future research should explore the role of lower-frequency FOT in assessing the severity and monitoring the progression of CF lung disease.
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Affiliation(s)
- Sotirios Fouzas
- Pediatric Respiratory Unit, Pediatric Department, University Hospital of Patras, Patras, Greece
| | - Christos Kogias
- Pediatric Respiratory and Cystic Fibrosis Unit, 3rd Paediatric Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Gioulvanidou
- Pediatric Respiratory and Cystic Fibrosis Unit, 3rd Paediatric Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aris Bertzouanis
- Pediatric Respiratory Unit, Pediatric Department, University Hospital of Patras, Patras, Greece
| | - Elisavet-Anna Chrysochoou
- Pediatric Respiratory and Cystic Fibrosis Unit, 3rd Paediatric Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - John Tsanakas
- Pediatric Respiratory and Cystic Fibrosis Unit, 3rd Paediatric Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Elpis Hatziagorou
- Pediatric Respiratory and Cystic Fibrosis Unit, 3rd Paediatric Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Hatziagorou E, Avramidou V, Gioulvanidou M, Talimtzi P, Kouroukli E, Mantsiou C, Lialias I, Nousia L, Tsanakas J. Pulmonary exacerbations, airway pathogens, and long-term course of lung clearance index in children and young adults with cystic fibrosis. Pediatr Pulmonol 2022; 57:3069-3076. [PMID: 36059241 DOI: 10.1002/ppul.26136] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 07/29/2022] [Accepted: 08/11/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Pulmonary exacerbations (PEx), pathogens colonizing the respiratory tract, and patients' age are associated with progressive worsening of lung function among patients with cystic fibrosis (CF). However, the effect of these factors on longitudinal changes of Lung Clearance Index (LCI) remains unclear. AIM To assess the role of age, different types of bronchial infection, and PEx on LCI deterioration. METHODS We conducted a retrospective study assessing multiple-breath washout (MBW) and spirometry changes among CF patients evaluated at quarterly outpatient clinic visits over 8 years. MBW and spirometry were performed at each visit, sputum samples and/or cough swabs were obtained for culture, whereas respiratory symptoms and clinical examination findings were recorded. Patients who had ≥5 serial MBW measurements, one of which coincided with a pulmonary exacerbation, were reviewed. RESULTS Seventy-six patients were included in the study: mean age of 10.61 years (range 1.75-23.75). A total of 1152 MBW tests and 1047 spirometry tests were performed. LCI was significantly higher among CF patients aged 11-15, 16-20, and over 20 years than those under 5 years of age; ΔLCI: 1.16 (confidence interval [CI] 0.43-1.90) and 3.25 (CI 2.33-4.17), respectively. Furthermore, LCI was significantly elevated in CF patients with positive cultures for Pseudomonas aeruginosa (0.52 LCI [CI -0.12 to 0.71]) and Stenotrophomonas Maltophilia (1.41 LCI [CI 0.61-2.21]). Moreover, increased values of LCI in CF patients were significantly associated with increased risk of PEx (odds ratio [OR] 1.19, CI [1.14-1.25], p < 0.001). CONCLUSION LCI demonstrates a progression of lung disease and corresponds to changes in bacterial infections and PEx among patients with CF. LCI may be a valuable marker for tracking disease deterioration and may have a role in the routine clinical care of patients with CF.
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Affiliation(s)
- Elpis Hatziagorou
- Pediatric Pulmonology and CF Unit, 3rd Pediatric Department, Hippokration Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasiliki Avramidou
- Pediatric Pulmonology and CF Unit, 3rd Pediatric Department, Hippokration Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Gioulvanidou
- Pediatric Pulmonology and CF Unit, 3rd Pediatric Department, Hippokration Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Persefoni Talimtzi
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleana Kouroukli
- Pediatric Pulmonology and CF Unit, 3rd Pediatric Department, Hippokration Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Chrysanthi Mantsiou
- Pediatric Pulmonology and CF Unit, 3rd Pediatric Department, Hippokration Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Lialias
- Pediatric Pulmonology and CF Unit, 3rd Pediatric Department, Hippokration Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lemonia Nousia
- Pediatric Pulmonology and CF Unit, 3rd Pediatric Department, Hippokration Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - John Tsanakas
- Pediatric Pulmonology and CF Unit, 3rd Pediatric Department, Hippokration Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Giannakoulakos S, Gioulvanidou M, Kouidi E, Peftoulidou P, Kyrvasili SS, Savvidou P, Deligiannis A, Tsanakas J, Hatziagorou E. Physical Activity and Quality of Life among Patients with Cystic Fibrosis. Children (Basel) 2022; 9:1665. [PMID: 36360393 PMCID: PMC9688592 DOI: 10.3390/children9111665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/25/2022] [Accepted: 10/28/2022] [Indexed: 03/14/2024]
Abstract
BACKGROUND Physical activity (PA) improves exercise capacity, slows the decline in lung function, and enhances Quality of Life (QoL) in patients with cystic fibrosis (pwCF). OBJECTIVES The study aimed to evaluate PA and QoL among children with CF compared to healthy controls; the secondary aim was to assess the correlation between PA, QoL, and lung function (FEV1). METHODS Forty-five children and adolescents with CF and 45 age-matched controls completed two self-administered validated questionnaires: The Godin Leisure-Time Exercise Questionnaire (GLTEQ) and the DISABKIDS for QoL. Moreover, pwCF performed spirometry and multiple breath washout tests (MBW). In addition, weight, height, and BMI were recorded. The Godin Leisure-Time Exercise Questionnaire was used to evaluate physical activity; QOL was assessed using the DISABKIDS Questionnaire. The correlation of PA with QOL was assessed as well. RESULTS Mean age of the CF population was 13.22 (±4.6) years, mean BMI 19.58 (±4.1) kg/m2, mean FEV1% 91.15 ± 20.46%, and mean LCI 10.68 ± 4.08. 68% of the CF group were active, 27% were medium active, 5% were sedentary, while 83% of the control group were active and 17% were medium active. PwCF with higher PA scores showed significantly higher emotional health (r2: 0.414, p: 0.006) and total QOL score (r2: 0.372; p: 0.014). The PA score showed no significant correlation with FEV1% or LCI. CONCLUSIONS The children with CF showed satisfactory PA levels, which positively correlated to their QoL. More research is needed on the effect of increased levels of habitual physical activity to establish the decline in pulmonary function among pwCF.
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Affiliation(s)
| | - Maria Gioulvanidou
- Pediatric Respiratory Unit, 3rd Paediatric Clinic, Aristotle University of Thessaloniki, Hippokration General Hospital of Thessaloniki, 54642 Thessaloniki, Greece
| | - Evangelia Kouidi
- Sports Medicine Laboratory, Aristotle University of Thessaloniki, 57001 Thermi, Greece
| | - Pauline Peftoulidou
- Pediatric Respiratory Unit, 3rd Paediatric Clinic, Aristotle University of Thessaloniki, Hippokration General Hospital of Thessaloniki, 54642 Thessaloniki, Greece
| | - Syrmo Styliani Kyrvasili
- Pediatric Respiratory Unit, 3rd Paediatric Clinic, Aristotle University of Thessaloniki, Hippokration General Hospital of Thessaloniki, 54642 Thessaloniki, Greece
| | - Parthena Savvidou
- Pediatric Respiratory Unit, 3rd Paediatric Clinic, Aristotle University of Thessaloniki, Hippokration General Hospital of Thessaloniki, 54642 Thessaloniki, Greece
| | - Asterios Deligiannis
- Sports Medicine Laboratory, Aristotle University of Thessaloniki, 57001 Thermi, Greece
| | - John Tsanakas
- Pediatric Respiratory Unit, 3rd Paediatric Clinic, Aristotle University of Thessaloniki, Hippokration General Hospital of Thessaloniki, 54642 Thessaloniki, Greece
| | - Elpis Hatziagorou
- Pediatric Respiratory Unit, 3rd Paediatric Clinic, Aristotle University of Thessaloniki, Hippokration General Hospital of Thessaloniki, 54642 Thessaloniki, Greece
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Fouzas S, Kogias C, Gioulvanidou M, Chrysochoou E, Anthracopoulos M, Tsanakas J, Hatziagorou E. 422 Specific respiratory conductance by forced oscillation to reveal ventilation inhomogeneity in patients with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01112-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Peftoulidou P, Gioulvanidou M, Chrysochoou EA, Hatziagorou E. Physical activity and quality of life in children with well-controlled asthma. J Asthma 2022; 60:1031-1037. [PMID: 36094169 DOI: 10.1080/02770903.2022.2123742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background: Asthma is the most common disease in childhood. Appropriate management and programs encouraging exercise enable children to enjoy a good quality of life (QoL).Objective: To assess the association between lung function, physical activity (PA), and QoL in children with well-controlled asthma.Methods: Fifty-four children aged 7 to 14 years attending a Pediatric Asthma Clinic were included. All children underwent spirometry and completed three self-administered validated questionnaires: The Godin Leisure-Time Exercise Questionnaire (GLTEQ), the ACT (Asthma Control Test), and the DISABKIDS for QoL.Results: Mean age of the study population was 11.43(±2.1), BMI, kg/m2 (20.8 ± 3.9), FVCpp (97.1% ±12.4), and FEV1pp (99.7% ±12.43), ACT (23.4 ± 3). The GLTEQ revealed that only 3% of the studied population presented satisfactory activity, while 86% were sedentary. Both FEV1pp, and PA were significantly correlated to the children's QoL ((r2: 0.55, p:0.0001), and (r2:0.45, p:0.003), respectively).Conclusions: Despite reasonable asthma control, the children exhibited low physical activity levels, which negatively correlated to their QoL. Families of asthmatic children should be educated to highlight the benefits of exercise and increase the PA of their children.
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Affiliation(s)
- Pauline Peftoulidou
- Aristotle University of Thessaloniki, Greece, Paediatric Pulmonology Unit, 3rd Paediatric Dept, Hippokration Hospital, Thessaloniki, Greece, 49 Konstantinoupoleo str, Thessaloniki, 54642 Greece
| | - Maria Gioulvanidou
- Aristotle University of Thessaloniki, Greece, Paediatric Pulmonology Unit, 3rd Paediatric Dept, Hippokration Hospital, Thessaloniki, Greece, 49 Konstantinoupoleo str, Thessaloniki, 54642 Greece
| | - Elissavet-Anna Chrysochoou
- Aristotle University of Thessaloniki, Greece, Paediatric Pulmonology Unit, 3rd Paediatric Dept, Hippokration Hospital, Thessaloniki, Greece, 49 Konstantinoupoleo str, Thessaloniki, 54642 Greece
| | - Elpis Hatziagorou
- Aristotle University of Thessaloniki, Greece, Paediatric Pulmonology Unit, 3rd Paediatric Dept, Hippokration Hospital, Thessaloniki, Greece, 49 Konstantinoupoleo str, Thessaloniki, 54642 Greece
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Hatziagorou E, Fouzas S, Kogias C, Gioulvanidou M, Chrysochoou EA, Tsanakas J. WS19.03 Respiratory impedance analysis at 5 Hz may reveal ventilation inhomogeneity in patients with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00263-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Chrysochoou EA, Hatziagorou E, Michailidou C, Gioulvanidou M, Galogavrou M, Tsanakas J. ePS1.05 Impact of COVID-19 on mental health among people with cystic fibrosis. J Cyst Fibros 2022. [PMCID: PMC9184786 DOI: 10.1016/s1569-1993(22)00283-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Peftoulidou P, Mouratidou IC, Chrysochoou EA, Gioulvanidou M, Galogavrou M, Hristara A, Hatziagorou E. ePS2.04 Is tele-physiotherapy as effective as home-visit-guided physiotherapy among children with cystic fibrosis? J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00292-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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