Lung sounds in bronchial asthma

Main Article Content

Yukio Nagasaka Michiko Tsuchiya

Abstract

Since the historical article by Forgacs in 1978, many studies have clarified the changes of lung sounds due to airway narrowing as well as the mechanism of genesis of these sounds. Studies using bronchoprovocation have shown that an increase of the frequency and/or intensity of lung sounds was a common finding of airway narrowing and correlated well with lung function in bronchial asthma. Bronchoprovocation studies also showed that wheezing may not be as sensitive as changes in basic lung sounds in acute airway narrowing in adult asthmatics.


In lung sound analysis, narrow airways cause an increase in the frequency of breath sounds and lung sound intensity, implying when the patient has higher than normal breath sounds, i.e., bronchial sounds, he or she may have airway narrowing. Recent studies reported that this increase of breath sounds suggested worsening of airway inflammation in rather stable patients with bronchial asthma. As it is difficult to detect subtle changes in lung sounds by auscultation alone, automated sound analysis will be expected.

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How to Cite
NAGASAKA, Yukio; TSUCHIYA, Michiko. Lung sounds in bronchial asthma. Medical Research Archives, [S.l.], v. 9, n. 7, july 2021. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2486>. Date accessed: 19 may 2022. doi: https://doi.org/10.18103/mra.v9i7.2486.
Section
Research Articles

References

1. Forgacs P. The functional basis of pulmonary sounds. Chest 1978; 73: 399-405.
2. Murphy RL. In defense of the stethoscope. Respir Care 2008; 53: 355-69.
3. Shimoda T, Nagasaka Y, Obase Y, Kishikawa R, Iwanaga T. Prediction of airway inflammation in patients with asymptomatic asthma by using lung sound analysis. J Allergy Clin Immunol Pract. 2014; 2: 727-32.
4. Habukawa C, Nagasaka Y, Murakami K, Takemura T. High-pitched breath sounds indicate airflow limitation in asymptomatic asthmatic children. Respirol. 2009; 14: 399-403.
5. Nagasaka Y. Lung Sounds in Bronchial Asthma. Allergol Int. 2012; 61: 353-63
6. Holtzman MJ, Fabbri LM, O'Byrne PM, Gold BD, Aizawa H, Walters EH, et al. Importance of airway inflammation for hyperresponsiveness induced by ozone. Am Rev Respir Dis. 1983; 127:686-90
7. Aizawa H, Chung KF, Leikauf GD, Ueki I, Bethel RA, O'Byrne PM, et al.. Significance of thromboxane generation in ozone-induced airway hyperresponsiveness in dogs. J Appl Physiol 1985; 59: 1918-23.
8. Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald JM, et al. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J 2008; 31: 143-178.
9. Shimoda T, Obase Y, Nagasaka Y, Nakano H, Kishikawa R, Iwanaga T. Lung sound analysis and airway inflammation in bronchial asthma. J Allergy Clin Immunol Pract. 2016; 4: 505-11.
10. Shimoda T, Obase Y, Nagasaka Y, Nakano H, Ishimatsu A, Kishikawa R, et al. Lung sound analysis helps localize airway inflammation in patients with bronchial asthma. J Asthma Allergy. 2017; 10: 99-108.
11. Habukawa C, Murakami K, Horii N, Yamada M, Nagasaka Y. Evaluation of airflow limitation using a new modality of lung sound analysis in asthmatic children. Allergology Int 2015; 64:84-9.
12. Mikami R, Murao M, Cugell DW, Chretien J, Cole P, Meier-Sydow J, et al. International symposium on lung sounds, synopsis of proceedings. Chest 1987; 92: 342-5.
13. Pasterkamp H, Montgomery M, Wiebicke W. Nomenclature used by health care professionals to describe breath sounds in asthma. Chest 1987; 92: 346-52.
14. Wilkins RL, Dexter JR, Murphy RL Jr, DelBono EA. Lung sound nomenclature survey. Chest 1990; 98: 886-9.
15. Nagasaka Y, Yasuda S, Ieda Y, Sugiura T. Changes of lung sound nomenclature in Japan since 1985 World Congress of Lung Sound. 32nd International Lung Sound Association Meeting, Tokyo, 2007.
16. Dalmay F, Antonini MT, Marquet P: Acoustic properties of the normal chest. Eur Respir J 1995; 8: 1761-9.
17. Nagasaka Y, Shimoda T, Yasuda S, Murakami K, Habukawa C. Numerical description of vesicular and bronchial breath sounds. 36th International Lung Sound Association Meeting, Manchester, UK, 2011.
18. Nagasaka Y, Yasuda S, Murakami K, Habukawa C, Kiyokawa H: Are “rhonchi” just a low pitch wheezes denoting bronchial narrowing or rumbling sounds denoting bronchial secretion? 35th International Lung Sound Association Meeting, Toledo, OH, USA, 2010
19. Nagasaka Y, Tsuchiya M, Nakanishi Y, Sakaguchi C, Ajimizu H, Morikawa N, et al. Rumbling rhonchi. Rumbling rhonchi in bronchial asthma: Their relation to airway inflammation. 42nd International Lung Sound Association Meeting, Tromso, Finland, 2017
20. Molfino NA, Slutsky AS, Hoffstein V, McClean PA, Rebuck AS, Drazen JM, et al. Changes in cross-sectional airway areas induced by methacholine, histamine and LTC4 in asthmatic subjects. Am Rev Resp Dis 1992; 146: 577-80.
21. Beck R, Dickson U, Montgomery MD, Mitchell I. Histamine challenge in young children using computerized lung sound analysis. Chest 1992; 102: 759-63.
22. Malmberg LP, Sorva R, Sovijarvi ARA. Frequency distribution of breath sounds as an indicator of bronchoconstriction during histamine challenge test in asthmatic children. Pediatr Pulmonol 1994; 18: 170-7.
23. Malmberg LP, Sovijarvi ARA, Paajanen E, Piirila P, Haahtela T, Katila T. Changes in frequency spectra of breath sounds during histamine challenge test in adult asthmatics and healthy control subjects. Chest 1994; 105: 122-132.
24. Anderson K, Aitken S, Carter R, Macleod JES, Moran F. Variation of breath sound and airway caliber induced by histamine challenge. Am Rev Respir Dis 1990; 141: 1147-50
25. Spence DPS, Bentley S, Evans DH, Morgan MDL. Effect of methacholine induced bronchoconstriction on the spectral characteristics of breath sounds in asthma. Thorax 1992; 47: 680-3.
26. Shreur HJW, Vanderschoot J, Zwinderman AH, Dijkman JH, Sterk PJ. Abnormal lung sounds in patients with asthma during episodes with normal lung function. Chest 1994; 106: 91-9.
27. Shreur HJW, Vanderschoot J, Zwinderman AH, Dijkman JH, Sterk PJ. The effect of methacholine-induced acute airway narrowing on lung sounds in normal and asthmatic subjects. Eur Respir J 1995; 8: 257-65.
28. Spence DP, Graham DR, Jamieson G, Cheetham BM, Calverley PM, Earis JE. The relationship between wheezing and lung mechanics during methacholine-induced bronchoconstriction in asthmatic subjects. Am J Respir Crit Care Med 1996; 154: 290-4.
29. Pasterkamp H, Consunji-Araneta R, Oh Y, Holbrow J. Chest surface mapping of lung sounds during methacholine challenge. Pediatr Pulmonol 1997; 23: 21-30.
30. Habukawa C, Murakami K, Mochizuki M, Takami S, Murayama R, Tadaki H, et al. Changes in the highest frequency of breath sounds without wheezing during methacholine inhalation challenge in children. Respirology, 2010; 15: 485-90.
31. Shreur HJW, Diamant Z, Vanderschoot J, Zwinderman AH, Dijkman JH, Sterk PJ. Lung sounds during allergen-induced asthmatic response in patients with asthma. Am J Respir Crit Care Med 1996; 153: 1474-80.
32. Niimi A, Matsumoto H, Amitani R, Nakano Y, Mishima M, Minakuchi M, et al. Airway wall thickness in asthma assessed by computed tomography. Relation to clinical indices. Am J Respir Crit Care Med 2000; 162: 1518-23.
33. Habukawa C, Murakami K, Sugitani K, Ohtani T, Saputra GP, Kashiyama K, et al. Changes in lung sounds during asthma progression in a guinea pig model. Allergology Int 2016; 65: 425-31.
34. Gavriely N, Kelly KB, Grotberg JB, Loring SH. Forced expiratory wheezes are a manifestation of airflow limitation. J Appl Physiol 1987; 62: 2398-403.
35. Gavriely N, Kelly KB, Grotberg JB, Loring SH. Critical pressure required for generation of forced expiratory wheezes. J Appl Physiol 1989; 66: 1136-42.
36. Beck R, Gavriely N. The reproducibility of forced expiratory wheezes. Am Rev Respir Dis 1990; 141: 1418-22.
37. Fiz JA, Jane R, Salvatella D, Izquierdo J, Lores L, P Caminal P, et al. Analysis of tracheal sounds during forced exhalation in asthma patients and normal subjects. Chest 1999; 116: 633-8.
38. Fiz JA, Jane R, Homs A, Izquierdo J, Garcia MA, MoreraJ. Detection of wheezing during forced exhalation in patients with obstructive airways. Chest 2002; 122: 186-91.
39. Pochektova IA, Korenbaum VI. Forced expiratory tracheal noise duration in bronchial obstruction among young men. Numerical description of vesicular and bronchial breath sounds [abstract]. The 34th Annual Conference of International Lung Sounds Association, Haifa, Israel, 2009.
40. Kraman SS. The forced expiratory wheeze. Its site of origin and possible association with lung compliance. Respiration 1983; 44: 189-96.
41. Korenbaum VI. Statistical simulation of vortex shedding on bronchial tree bifurcations as mechanism of tracheal forced expiratory wheezes origin healthy subjects [abstract]. The 34th Annual Conference of International Lung Sounds Association, Haifa, Israel, 2009.
42. Korenbaum VI, Safronova M, Dyachenko A, Pochektova IA. Statistical analysis of forced expiratory wheezes origin healthy subjects [abstract]. The 35th Annual Conference of International Lung Sounds Association, Toledo, OH, USA, 2010.
43. Dyachenko A, Korenbaum VI, Tagiltsev A. Measurements of forced expiratory noise over trachea and infrascapular region [abstract]. The 36th Annual Conference of International Lung Sounds Association, Manchester, UK, 2011.
44. Gavriely N, Palti Y, Alroy G, Grotberg JB. Measurement and theory of wheezing breath sound. J Appl Physiol 1984; 57: 481-92.
45. Gavriely N. Inspiratory wheezes and intra-thoracic inspiratory flow limitation [abstract]. The 34th Annual Conference of International Lung Sounds Association, Haifa, Israel, 2009
46. Akasaka K, Konno K, Ono Y, Mue S, Abe C. Acoustical studies on respiratory sounds in asthmatic patients. Tohoku J Exp Med 1975; 117: 323-33
47. Nagasaka Y, Yasuda S, Ieda Y, Komiya T, Hatanaka T, Sugitatu S, et al. An analysis of the pitch of the wheezing in bronchial asthma. Clinical Pharmacology and Therapy. 2004; 14: 547-52 (in Japanese with an English abstract).
48. Rietveld S, Dooijes EH, Rijssenbeek-Nouwens LHM, SmitF, Prins PJM, Kolk AMM, et al. Characteristics of wheeze during histamine-induced airway obstruction in children with asthma. Thorax 1995; 50: 143-8.
49. Nagasaka Y, Tsuchiya M, Minami T, Kominami R, Yamada R, Igarachi T, et al. Airway Inflammation and wheezes - monophonic or polyphonic. J Jap Resp Soci. 2013; 2: s353
50. Pasterkamp H. Psychoacoustics of auscultation. 42nd International Lung Sound Association Meeting, Tromso, Finland, 2017
51. Lehrer S. Understanding lung sounds. 3rd Ed New York: WB Saunders; 2002.
52. Sera T, Tanishita K. Anatomical aspects of airway flow and gas transport in the pulmonary system. Med Imag Tech 2002; 20: 654-9. (in Japanese with an English abstract)
53. Nagasaka Y, Shimoda T, Yasuda S, Murakami K, Habukawa C. Numerical description of vesicular and bronchial breath sounds. 35th International Lung Sound Association Meeting, Toledo, OH, USA, 2011.
54. Nagasaka Y, Yasuda S, Ieda Y, Shimoda S, Habukawa C. Vesicular and broncho-vesicular sounds and airway inflammation in asthma. 30th International Lung Sound Association Meeting, Halkidiki, Greece, 2006.
55. Shimoda T, Obase Y, Nagasaka Y, Nakano H, Kishikawa R, Iwanaga T. Airway inflammation phenotype prediction in asthma patients using lung sound analysis with fractional exhaled nitric oxide. Allergol Int. 2017; 66: 581-5.
56. Shimoda T, Obase Y, Nagasaka Y, Nakano H, Kishikawa R, Iwanaga T. Peripheral bronchial obstruction evaluation in patients with asthma by lung sound analysis and impulse oscillometry. Allergol Int. 2017; 66: 132-8
57. Shimoda T, Obase Y, Nagasaka Y, Nakano H, Kishikawa R, Iwanaga T. Lung sound analysis and the respiratory cycle dependence of oscillometry in asthma patients. Intern Med. 2019; 58: 47-52.
58. Shimoda T, Obase Y, Nagasaka Y, Nakano H, Kishikawa R, Iwanaga T. Lung sound analysis can be an index of the control of bronchial asthma. Allergol Int. 2017; 66: 64-9
59. Shimoda T, Obase Y, Nagasaka Y, Nakano H, Kishikawa R, Iwanaga T. Lung sound analysis is useful for monitoring therapy in patients with bronchial asthma. J Investig Allergol Clin Immunol. 2017; 27: 246-51.
60. Shimoda T, Obase Y, Nagasaka Y, Asai S. Phenotype classification using the combination of lung sound analysis and fractional exhaled nitric oxide for evaluating asthma treatment. Allergol Int. 2018; 67: 253-8.
61. Charbonneau G, Racineux JL, Sudraud M, Tuchais E. An accurate recording system and its use in breath sounds spectral analysis. J Appl Physiol. 1983; 55: 1120-7.
62. Tinkelman DG, Lutz C, Conner B. Analysis of breath sounds in normal and asthmatic children and adults using computer digitized airway phonography (CDAP). Respir Med. 1991; 85: 125-31.
63. Malmberg LP, Kallio K, Haltsonen S, Katila T, Sovijarvi ARA. Classification of lung sounds in patients with asthma, emphysema, fibrosing alveolitis and healthy lungs by using self-organizing maps. Clin Physiol. 1996; 16: 115-29.
64. Lenclud C, Cuttita G, Gansbeke DG, Visconti A, Muylem AV, Bellia A, et al. Evaluation of nocturnal bronchoconstriction by all night tracheal sound monitoring. Thorax 1996; 51: 694-8.
65. Rietveld S, Oud M, Rijssenbeek-Nouwens LHM, Vaghi D, Dooijes EH. Characteristics of diagnostic significance of spontaneous wheeze in children with asthma. Results of continuous in vivo sound recording. J Asthma 1999; 36: 351-8.
66. Gavriely N. Digital data acquisition and preprocessing of breath sounds. In: Gavriely N. Breath sounds methodology. Boca Raton, FL: CRC Press, 1995; p. 55-97.
67. Prodhan P, Dela Rosa RS, Shubina M, Haver KE, Matthews BD, Buck S, et al. Wheeze detection in pediatric intensive care unit: Comparison among physician, nurses, respiratory therapists, and a computerized respiratory sound monitor. Respir Care 2008; 53: 1304-9.
68. Boner AL, Piacentini GL, Peroni DG, Irving CS, Goldstein D, Gavriely N, Godfrey S. Children with nocturnal asthma wheeze intermittently during sleep. J Asthma 2010; 47: 290-4.
69. Bibi H, Gavriely N. Cough monitoring during bronchodilator administration in pediatric asthma. 34th International Lung Sound Association Meeting, Haifa, Israel, 2009.
70. Habukawa C, Murakami K, Horii N, Yamada M, Nagasaka Y. The influence of airflow and body size on breath sounds in healthy children. Jpn J Clin Physiol 2011; 41: 69-74.
71. Habukawa C, Murakami K, Endoh M, Horii N, Nagasaka Y. Treatment evaluation using lung sound analysis in asthmatic children. Respirology. 2017; 22: 1564-9