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Determining airflow obstruction from tracheal sound analysis: simulated tests and evaluations in patients with acromegaly

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Abstract

To evaluate the ability of tracheal sound analysis (TSA) to detect airflow obstruction, particularly in patients with acromegaly. A simulated analysis compared free airflow conditions with airflow through orifice plates 6, 8, 10 and 12 mm in diameter. Based on these results, TSA and spirometry examinations were performed on controls (n = 17) and patients with acromegaly (n = 17). The simulated study showed that airway obstruction and airflow values increased the values of power and a progressive displacement of the spectral distribution towards higher frequencies. In agreement with the simulation, airway obstruction in patients with acromegaly also resulted in increased values of power (p < 0.002) and displacement of the spectral distribution (p < 0.01). Significant associations were observed between the TSA parameters and the spirometry indices of obstruction (p < 0.02). In addition, the TSA parameters achieved adequate diagnostic accuracy (AUC ≥ 0.887). The present study provides evidence that TSA during resting breathing would provide adequate biomarkers of early upper airway changes in patients with acromegaly. TSA is carried out during spontaneous ventilation, requires little from the patient, and is fast and inexpensive. Taken together, these practical considerations and the results of the present study suggest that TSA may improve lung function tests for patients with acromegaly.

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Summary of the study, overall design flow and the main results obtained.

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Abbreviations

%pred:

Percentage of the predicted values

AG:

Group with acromegaly

AUC:

Area under the receiver operating characteristic curve

CG:

Control group

FEF:

Forced expiratory flow between 25 and 75% of the FVC (L/s)

FEV1 :

The forced expiratory volume in the first second, obtained from a maximal expiratory effort manoeuvre (L)

FEV1/FVC:

Tiffeneau–Pinelli index

FVC:

Forced vital capacity, the total amount of air exhaled during the spirometry examinations (L)

LOOCV:

Leave-one-out cross-validation

PEF:

Peak expiratory flow (L/s)

Pm:

Mean power in the complete studied frequency range (100 to 2500 Hz) (dB)

PmLF:

Mean power in the frequency range of 130–250 Hz (dB)

PmLFnorm :

Mean power in the frequency range of 130–250 Hz normalized to the mean power observed at 0.2 L/s (dB)

Pmnorm :

Mean power normalized to the mean power observed at 0.2 L/s (dB)

ROC:

Receiver operating characteristic curve

S:

The slope of the regression line in the power spectra (db/dec)

Se:

Sensitivity, the proportion of actual positives that are correctly identified as such

Sp:

Specificity, the proportion of actual negatives that are correctly identified as such

TSA:

Tracheal sounds analysis

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Acknowledgements

This study was supported by the Brazilian Council for Scientific and Technological Development (CNPq), the Rio de Janeiro State Research Supporting Foundation (FAPERJ) and in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001.

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Authors and Affiliations

  1. Biomedical Instrumentation Laboratory, Institute of Biology and Faculty of Engineering, State University of Rio de Janeiro, Rio de Janeiro, Brazil

    Newton A. Lima Junior, Nayara V. Oliveira & Pedro L. Melo

  2. Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil

    Ana B. W. Tavares

  3. Pulmonary Function Laboratory, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil

    Agnaldo J. Lopes

  4. Rehabilitation Sciences Postgraduate Program, Augusto Motta University Center, Rio de Janeiro, Brazil

    Agnaldo J. Lopes

  5. Laboratory of Clinical and Experimental Research in Vascular Biology, Institute of Biology, State University of Rio de Janeiro, Rio de Janeiro, Brazil

    Pedro L. Melo

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  1. Newton A. Lima Junior
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Lima Junior, N.A., Oliveira, N.V., Tavares, A.B.W. et al. Determining airflow obstruction from tracheal sound analysis: simulated tests and evaluations in patients with acromegaly. Med Biol Eng Comput 60, 2001–2014 (2022). https://doi.org/10.1007/s11517-022-02584-2

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