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Hyperpolarized 3 He MRI previously revealed spatially persistent ventilation defects in healthy older compared with healthy younger never-smokers To understand better the physiological consequences and potential relevance of 3 He MRI ventilation defects we evaluated 3 He-MRI ventilation-defect percent VDP and the effect of deep inspiration DI and salbutamol on VDP in older never-smokers To identify the potential determinants of ventilation defects in these subjects we evaluated dyspnea pulmonary function and cardiopulmonary exercise test CPET measurements as well as occupational and second-hand smoke exposure Fifty-two never-smokers 71 6 yr with no history of chronic respiratory disease were evaluated During a single visit pulmonary function tests CPET and 3 He MRI were performed and the Burden of Obstructive Lung Disease questionnaire administered For eight of 52 subjects there was spirometry evidence of airflow limitation Global Initiative for Chronic Obstructive Lung Disease-Unclassified I and II and occupational exposure was reported in 13 of 52 subjects In 13 of 52 25 subjects there were no ventilation defects and in 39 of 52 75 subjects ventilation defects were observed For those subjects with ventilation defects six of 39 showed a VDP response to DI salbutamol Ventilation heterogeneity and VDP were significantly greater and forced expiratory volume in 1 s FEV1 forced vital capacity was significantly lower P 0 05 for subjects with ventilation defects with a response to DI salbutamol than subjects with ventilation defects without a response to DI salbutamol and subjects without ventilation defects In a step-wise forward multivariate model FEV1 inspiratory capacity and airway resistance significantly predicted VDP R 2 0 45 P 0 001 In conclusion most never-smokers had normal spirometry and peripheral ventilation defects not reversed by DI salbutamol such ventilation defects were likely related to irreversible airway narrowing collapse but not to dyspnea and decreased exercise capacity

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Pulmonary ventilation defects in older never-smokers.

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with pulmonary aging as keyword