| Computed tomography assessment of pharmacological lung volume reduction induced by bronchodilators in COPD. | |
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MedLine Citation:
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PMID: 22509949 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Abstract Pharmacological lung volume reduction in COPD is an important goal in treatment with long-acting bronchodilators because in addition to airflow limitation, lung hyperinflation considerably affects COPD symptoms. Quantitative computed tomography (CT) simultaneously provides structural information about airway dimensions, emphysematous changes, and lung volumes, some of which are difficult to be evaluated by pulmonary function. Here, we evaluated changes in CT parameters and pulmonary function in 30 patients with COPD who underwent CT scans before and one year after starting tiotropium treatment and in 12 patients with COPD who were not treated with long-acting bronchodilators. Baseline pulmonary function and CT parameters did not differ between the two groups. One-year tiotropium therapy improved physiological-indices including residual volume (RV) and ratio of RV to total lung capacity (RV/TLC) (-235 mL, p = 0.005, and -2.9%, p = 0.0001, respectively), and CT-indices including wall area percent (WA%) and inner luminal area in right upper lobe apical and lower lobe basal segmental bronchi (-1.59%, p = 0.01, 2.27 mm(2), p = 0.0005; and -1.33%, p = 0.0008, 3.42 mm(2), p < 0.0001, respectively), low attenuation volume (LAV) and total lung volume (CT-TLV) (-92 mL, p = 0.0003, and -211 mL, p = 0.002, respectively). Changes in LAV, CT-TLV, RV, and RV/TLC were significantly greater in the tiotropium, than the non-bronchodilator group. The tiotropium-induced reduction in LAV correlated with the decrease in RV (ρ = 0.45, p = 0.01). Our findings not only indicate the value of the comprehensive CT measurements in assessing the effects of bronchodilators, including pharmacological lung volume reduction, but also further understanding of the structural changes underlying physiological improvements induced by bronchodilators. |
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Authors:
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Naoya Tanabe; Shigeo Muro; Tsuyoshi Oguma; Susumu Sato; Hirofumi Kiyokawa; Tamaki Takahashi; Megumi Kudo; Daisuke Kinose; Takeshi Kubo; Yuma Hoshino; Emiko Ogawa; Toyohiro Hirai; Michiaki Mishima |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-4-18 |
Journal Detail:
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Title: COPD Volume: - ISSN: 1541-2563 ISO Abbreviation: - Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-4-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101211769 Medline TA: COPD Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University , Kyoto , Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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