The evolving science of ventilation heterogeneity: From pathophysiology to personalized therapeutic approaches

Although inherent to normal lung physiology, ventilation heterogeneity (VH) often becomes an underrecognized clinical problem in a variety of respiratory conditions characterized by an asymmetric distribution of pathologic processes and the presence of regional mismatching between ventilation and perfusion. Traditional functional diagnostic approaches have been mostly focused on the role of VH in airway diseases, but with the development of novel diagnostic approaches capable of diagnosing both temporal and spatial VH in lung disease, we have the opportunity to better understand the clinical significance of VH in all lung disease. In this concise review, we aim to discuss the physiologic, radiologic, and clinical impacts of VH on pulmonary disease, highlighting the developing technologies to detect and treat it.