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Conditions associated with severe carbon monoxide diffusion coefficient reduction.
MedLine Citation:
PMID:  21454061     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To identify conditions associated with severe carbon monoxide transfer coefficient reduction (Kco < 40% of predicted values). PATIENTS AND METHODS: We retrospectively reviewed pulmonary function tests, such as Kco measurement, in consecutive patients evaluated in the physiology unit of a University hospital over a 6-year period. Patients were included if they had at least 1 measure of severe Kco reduction, with further detailed pulmonary function tests, clinical data, and diagnostic procedures conducted within 6 months. RESULTS: 5576 patients underwent 9061 Kco measurements. 195 patients (3.5%) with Kco < 40% were investigated (156 males; mean age 62 ± 12 years). Mean Kco was 29 ± 9% of predicted values. The main conditions associated with severe Kco reduction were: emphysema (46%); interstitial lung disease (28%); combined pulmonary fibrosis and emphysema (16%); and pre-capillary pulmonary hypertension (8%). Systolic pulmonary artery pressure was ≥35 mmHg at echocardiography in 88% of patients. Right heart catheterization performed in 97 patients showed pre-capillary pulmonary hypertension in 86 of 195 patients (44%). Pulmonary hypertension was the most frequent condition associated with Kco severe reduction. Pulmonary hypertension was present in 29%, 53%, and 48% of patients with chronic obstructive pulmonary disease, interstitial lung disease, and combined pulmonary fibrosis and emphysema, respectively, and was disproportionate to the parenchymal lung disease (mean pulmonary artery pressure > 35 mmHg) in 63% of cases. CONCLUSION: Severe Kco reduction is frequently related to pulmonary hypertension, especially when associated with emphysema and/or interstitial lung disease. Systematic echocardiography is thus warranted in any patient with severe Kco diminution.
Authors:
Lize Kiakouama; Vincent Cottin; Jean-Charles Glerant; Jean-Yves Bayle; Jean-François Mornex; Jean-François Cordier
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-29
Journal Detail:
Title:  Respiratory medicine     Volume:  -     ISSN:  1532-3064     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-4-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Ltd.
Affiliation:
Hospices Civils de Lyon, Hôpital Louis Pradel, Service de Pneumologie - Centre de Référence des Maladies Rares Pulmonaires, France; Université de Lyon, Université Lyon I, UMR754 INRA-Vetagrosup EPHE, IFR128, Lyon, France.
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