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Articles in PresS, published online ahead of print December 6, 2002
J Appl Physiol, 10.1152/jap.00588.2002
Submitted on July 2, 2002
Accepted on October 8, 2002
1 Academic Hosptial, Respiratory Division, Vrije Universiteit Brussel, Brussels, Belgium
2 Biomedical Physics Laboratory, Universite Libre de Bruxelles, Brussels, Belgium
* To whom correspondence should be addressed. E-mail: sylvia.verbanck{at}az.vub.ac.be.
A multiple breath washout technique was used to assess residual ventilation heterogeneity in the conductive and acinar lung zones of asthmatic patients after maximal 
2 agonist reversibility. Reversibility was assessed in 13 patients on two separate visits corresponding to a different baseline condition in terms of FEV1 (average FEV1 over two visits: 92±21(SD)%predicted). On the visit corresponding to each patient's best baseline, 400µg salbutamol led to normal acinar ventilation heterogeneity, normal FEV1 and normal PEF, i.e., none were significantly different from that obtained in 13 matched controls. By contrast, conductive ventilation heterogeneity and forced end-expiratory flow FEF75 remained significantly different from controls (p
0.005 on both indices). In addition, the degree of post-dilation conductive ventilation heterogeneity was similar to what was previously obtained in asthmatics with a 19% lower baseline FEV1 and twofold larger acinar ventilation heterogeneity (Am J Respir Crit Care Med 159:1545-1550,1999). We conclude that even in the mildest forms of asthma the most consistent pattern of non-2-reversible ventilatory heterogeneity is in the conductive lung zone, most probably in the small conductive airways.
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