| Annual Change in Pulmonary Function and Clinical Phenotype in Chronic Obstructive Pulmonary Disease. | |
| | |
MedLine Citation:
|
PMID: 22016444 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
RATIONALE: Although the rate of annual decline in forced expiratory volume in one second (FEV1) is one of the most important outcome measures in chronic obstructive pulmonary disease (COPD), little is known about inter-subject variability based on clinical phenotypes. OBJECTIVES: To examine the inter-subject variability in a 5-year observational cohort study, particularly focusing on emphysema severity. METHODS: A total of 279 eligible patients with COPD (Stage I to IV: 26, 45, 24, and 5%) participated. We conducted a detailed assessment of pulmonary function and computed tomography (CT) at baseline, and performed spirometry every 6 months before and after inhalation of bronchodilator. Smoking status, exacerbation and pharmacotherapy were carefully monitored. Emphysema severity was evaluated by CT and annual measurements of carbon monoxide transfer coefficient (Kco). MEASUREMENTS AND MAIN RESULTS: Using mixed effects model analysis, the annual decline in post-bronchodilator FEV1 was -32 ± 24 (SD) ml/y (n=261). We classified the subjects of < the 25th percentile as Rapid decliners, the 25th -75th percentile as Slow decliners, and > the 75th percentile as Sustainers (-63±2, -31±1, and -2±1 (SE) ml/y). Emphysema severity, but not %FEV1, showed significant differences among the three groups. Multiple logistic regression analysis demonstrated that the Rapid decliners were independently associated with emphysema severity assessed either by CT or Kco. The Sustainers displayed less emphysema and higher levels of circulating eosinophils. CONCLUSIONS: Emphysema severity is independently associated with a rapid annual decline in FEV1 in COPD. Sustainers as well as Rapid decliners warrant specific attention in clinical practice. |
| | |
Authors:
|
Masaharu Nishimura; Hironi Makita; Katsura Nagai; Satoshi Konno; Yasuyuki Nasuhara; Masaru Hasegawa; Kaoruko Shimizu; Tomoko Betsuyaku; Yoichi M Ito; Satoshi Fuke; Takeshi Igarashi; Yasushi Akiyama; Shigeaki Ogura; |
Related Documents
:
|
22154684 - Short echo time in vivo prostate (1)h-mrsi. 21610394 - Development of a computed tomography-based scoring system for necrotizing soft-tissue i... 21785884 - Hemodynamics and in-stent restenosis: micro-ct images, histology, and computer simulati... 1429104 - Radiosurgery target point alignment errors detected with portal film verification. 21820604 - A moderate-intensity static magnetic field enhances repair of cartilage damage in rabbits. 16127534 - Septum formation of the lateral ventricles. |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-10-20 |
Journal Detail:
|
Title: American journal of respiratory and critical care medicine Volume: - ISSN: 1535-4970 ISO Abbreviation: - Publication Date: 2011 Oct |
Date Detail:
|
Created Date: 2011-10-21 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9421642 Medline TA: Am J Respir Crit Care Med Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
First Department of Medicine, Hokkaido University School of Medicine, North 15, West 7, Kita-ku, 060-8638, Sapporo, 060-8638, Japan. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Sedation and Analgesia in the Mechanically Ventilated Patient.
Next Document: Neurogenic Changes in the Upper Airway of Obstructive Sleep Apnea Patients.