Influence of bronchomotor tone on regional ventilation distribution at residual volume

Abstract

We studied the topographical distribution of 133Xe boluses inhaled slowly from RV, as well as the distribution of regional volumes at RV (RVr) in seven seated normal subjects before and after aerosolized isoprenaline (ISO) and after aerosolized methacholine hydrochloride (Mech). After Mech the ratio of inhaled 133Xe in the upper lung regions to that in lower lung regions (U/L) decreased from 3.21 +/- .33 (mean +/- 1 SE) to 1.27 +/- 0.12 (P less than 0.001) and returned to 3.89 +/- 0.55 after Iso. Iso alone increased U/L from 3.23 +/- 0.47 to 5.49 +/- 0.85 (P less than 0.025). The height of phase IV in expired 133Xe vs. volume plots correlated with U/L, being greater after Iso and smaller after Mech in each subject. The difference in RVr between upper and lower lung regions decreased after Mech in four out of five subjects from 0.22 TLC to 0.11 TLC. Iso alone did not change the gradient of RVr. The results are consistent with the concept that increased bronchomotor tone widens the range of critical opening and closing pressures with a more patchy and extensive distribution of airway closure.