Return to content in this issue
Dynamic Hyperinflation in Patients With Moderate-Severe Asthma: Relationship With Clinical Control and Small Airway Dysfunction
Saldaña-Pérez LE1,2, Serrano Pariente J1,3,4, Cisneros Serrano C1,5,6, Plaza V7, Ali-García I1,8, Campano Lancharro FJ1,9, Sánchez Cuellar S1,10, García Onieva AI1,11, Mardones A1,12, Curto Sánchez E1,13, Muñoz Esquerre M1,14, Galera-Martínez R15, Valenzuela Reyes P1,16, Ojanguren Arranz Í1,17, Marcos MC1,5, Benito Bernáldez C18, Lobato Astiárraga I19, Díaz-Campos RM1,20, García-Río F1,21
1Grupo Emergente de Asma (GEA) de SEPAR, Spain
2Servicio de Neumología, Hospital Universitario de Getafe, Madrid, Spain
3Servicio de Neumología, Hospital Comarcal de Inca, Baleares, Spain
4Instituto de Investigación Sanitaria Illes Balears (IdISBa)
5Servicio de Neumología, Hospital Universitario de La Princesa, Madrid, Spain
6IIS Princesa, Madrid, Spain
7Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
8Servicio de Neumología, Hospital Universitario Infanta Leonor, Madrid, Spain
9Servicio de Neumología, Hospital Universitario de Navarra, Pamplona, Spain
10Servicio de Neumología, Hospital Universitario Ramón y Cajal, Madrid, Spain
11Servicio de Neumología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
12Servicio de Neumología, Hospital Universitario Basurto, Bilbao, Spain
13Servicio de Neumología, Hospital Universitario de Salamanca, Spain
14Servicio de Neumología, Hospital Universitario de Bellvitge – IDIBELL, Barcelona, Spain
15Servicio de Neumología, Hospital Universitario La Paz, Madrid, Spain
16Servicio de Neumología, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
17Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, Spain
18Servicio de Neumología, Hospital Universitario Virgen Macarena, Sevilla, Spain
19Servicio de Neumología, Hospital Nuestra Señora de Sonsoles, Ávila, Spain
20Servicio de Neumología, Hospital Universitario 12 de Octubre, Madrid, Spain
21Servicio de Neumología, Hospital Universitario la Paz - IdiPAZ, Madrid, Spain
J Investig Allergol Clin Immunol 2026; Vol. 36(3)
doi: 10.18176/jiaci.1088
Background: Dynamic hyperinflation (DH), characterized by an abnormal increase in operative lung volumes during exercise, is associated with breathlessness and exercise intolerance. This study aimed to evaluate the relationship between DH and control of symptoms in patients with moderate-severe asthma.
Methods: A cross-sectional, multicenter, observational study was conducted in patients with moderate-severe asthma. DH was defined as a decrease in inspiratory capacity after a 6-minute walk test (6MWT), and asthma control was measured using the Asthma Control Test (ACT) and Spanish Guidelines for the Management of Asthma (GEMA). Secondary variables included sensitization to aeroallergens (prick test), quality of life (miniAQLQ), anxiety or depression, dyspnea (mMRC), fatigue (Borg scale), and small airway dysfunction (oscillometry).
Results: Among the 154 patients analyzed, 97 (63%) had DH. ACT scores did not differ significantly between patients with and without DH (20.8 [4.4] vs 21.7 [3.6]; P=.411). However, the percentage of patients with partially and poorly controlled asthma according to GEMA was significantly higher in the DH group than in those without DH (40.2% vs 24.6%; P=.048). Compared with patients without DH, patients with DH had higher dyspnea scores (0.9 [0.9] vs 0.5 [0.6]; P=.009), greater fatigue before the 6MWT (1.3 [1.9] vs 0.5 [1.1]; P=.004), higher respiratory reactance (0.7 [1.2] vs 0.4 [1.2] cmH2O/L/s; P=.032), higher depression scores (4.2 [3.7] vs 2.1 [2.1], P=.002), and lower sensitization to aeroallergens (45.4% vs 68.4%; P=.014).
Conclusion: Although no relationship was found between DH and uncontrolled asthma via the ACT, the proportion of patients with uncontrolled asthma according to GEMA was significantly higher in the DH group.
Key words: Asthma control, Dynamic hyperinflation, Oscillometry, Dyspnea, Prevalence
