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Abstract

The purpose of this study was to evaluate the synergistic value of combined capnography, impulse oscillometry (IOS), and CT densitometry (qCT) for precision phenotyping in chronic respiratory diseases. The study included 85 patients with COPD, bronchial asthma, ILD, and their cardiac comorbidities, and 30 control subjects. All participants underwent a comprehensive assessment using IOS, resting capnography, and chest CT with quantitative densitometric analysis. Patients with COPD and concomitant heart failure exhibited the most severe impairments: small airway resistance (R5-R20) reached 0.28±0.11 kPa/L/s, the air trapping index (AX) was 2.87±1.24 kPa/L, and end-tidal CO₂ concentration (EtCO₂) decreased to 27.8±5.2 mm Hg versus 38.2±2.1 in controls. CT densitometry objectively confirmed the structural basis: the emphysema index (LAA-950%) in this subgroup was 25.1±12.8%, and the expiratory air trapping volume was 45.8±16.3%. Correlation analysis revealed strong associations between functional and structural parameters: between AX (IOS) and air trapping on qCT (r=0.81, p<0.001), and between the calculated dead space index and air trapping volume (r=0.76, p<0.001). The integration of capnography, IOS, and qCT provides a powerful synergistic approach. It enables quantitative discrimination of contributions from airway obstruction, gas exchange impairment, and structural remodeling, providing a solid foundation for personalized therapeutic strategies in complex cardiorespiratory disease‎.

Keywords: Integrated monitoring, Impulse oscillometry, Capnography, CT densitometry, Precision pulmonology, Phenotyping

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