scholarly journals Characterisation of gas exchange in COPD with dissolved-phase hyperpolarised xenon-129 MRI

Thorax ◽  
2020 ◽  
pp. thoraxjnl-2020-214924
Author(s):  
Lukasz Myc ◽  
Kun Qing ◽  
Mu He ◽  
Nicholas Tustison ◽  
Zixuan Lin ◽  
...  
Keyword(s):  
Blood Cells ◽  
Forced Expiratory Volume ◽  
Chest Ct ◽  
Chronic Obstructive ◽  
Gas Transfer ◽  
Diffusing Capacity ◽  
Obstructive Pulmonary Disease ◽  
Diffusion Capacity ◽  
Capacity Limitations ◽  
Dissolved Phase

To investigate whether hyperpolarised xenon-129 MRI (HXeMRI) enables regional and physiological resolution of diffusing capacity limitations in chronic obstructive pulmonary disease (COPD), we evaluated 34 COPD subjects and 11 healthy volunteers. We report significant correlations between airflow abnormality quantified by HXeMRI and per cent predicted forced expiratory volume in 1 s; HXeMRI gas transfer capacity to red blood cells and carbon monoxide diffusion capacity (%DLCO); and HXeMRI gas transfer capacity to interstitium and per cent emphysema quantified by multidetector chest CT. We further demonstrate the capability of HXeMRI to distinguish varying pathology underlying COPD in subjects with low %DLCO and minimal emphysema.

scholarly journals Prognostic Marker for Severe Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Analysis of Diffusing Capacity of the Lung for Carbon Monoxide (DLCO) and Forced Expiratory Volume in One Second (FEV1)

2021 ◽  
Author(s):  
Juwhan Choi ◽  
Jae Kyeom Sim ◽  
Jee Youn Oh ◽  
Young Seok Lee ◽  
Gyu Young Hur ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Length Of Hospital Stay ◽  
Forced Expiratory Volume ◽  
Curve Analysis ◽  
Chronic Obstructive ◽  
Diffusing Capacity ◽  
Roc Curve Analysis ◽  
Obstructive Pulmonary Disease

Abstract Background: It is important to assess the prognosis and classify patients in chronic obstructive pulmonary disease (COPD) and acute exacerbation of COPD (AECOPD) treatment. Recently, it was suggested that diffusing capacity of the lung for carbon monoxide (DLCO) should be added to multidimensional tools for assessing COPD. This study aimed to compare the DLCO and forced expiratory volume in one second (FEV1) to identify better prognostic factors for admitted patients with AECOPD.Methods: We retrospectively analyzed 342 patients with AECOPD receiving inpatient treatment. We classified 342 severe AECOPD events using DLCO and FEV1. We defined the prognostic factors of severe AECOPD as the length of hospital stay, mortality in hospital, experience of mechanical ventilation, and experience of intensive care unit (ICU) care. We analyzed the prognostic factors by multivariate analysis using logistic regression. In addition, we conducted a correlation analysis and receiver operating characteristic (ROC) curve analysis.Results: In univariate and multivariate analyses, DLCO was shown to predict mortality rate (odds ratio = 4.408; 95% confidence interval, 1.070–18.167; P = 0.040), experience of ventilator (odds ratio = 2.855; 95% confidence interval, 1.216–6.704; P = 0.016) and ICU (odds ratios = 2.685; 95% confidence interval, 1.290–5.590; P = 0.008). However, there was no statistically significant difference in mortality rate when using FEV1 classification (P = 0.075). In the correlation analysis, both DLCO and FEV1 showed a negative correlation with length of hospital stay. The correlation rate was more pronounced in the DLCO (DLCO; B = -0.103, P < 0.001) (FEV1; B = -0.075, P = 0.007). In addition, DLCO showed better predictive ability than FEV1 in ROC curve analysis. The area under the curve (AUC) of DLCO was greater than 0.68 for all prognostic factors, and in contrast, the AUC of FEV1 was less than 0.68.Conclusion: DLCO was likely to be as good as or better prognostic marker than FEV1 in severe AECOPD.

Distinctive patterns of pulmonary function change according to baseline lung volume and diffusing capacity

2020 ◽  
Vol 24 (6) ◽  
pp. 597-605
Author(s):  
J. Kang ◽  
Y-M. Oh ◽  
J-H. Lee ◽  
E. K. Kim ◽  
S. Y. Lim ◽  
...  
Keyword(s):  
South Korea ◽  
Pulmonary Function ◽  
Lung Volume ◽  
Forced Expiratory Volume ◽  
Random Coefficients ◽  
Chronic Obstructive ◽  
Diffusing Capacity ◽  
Obstructive Pulmonary Disease ◽  
Function Change ◽  
Physiological Markers

SETTING: Multicentre retrospective study in South Korea.OBJECTIVE: To longitudinally evaluate changes in lung volume and diffusing capacity for carbon monoxide (DLCO) with forced expiratory volume in 1 sec (FEV1).DESIGN: A total of 155 patients with chronic obstructive pulmonary disease (COPD), whose pulmonary function parameters were measured annually for 5 years, were selected from a prospective cohort in South Korea. A random coefficients model was used to estimate mean annual FEV1, lung volume parameter and DLCO change rates.RESULTS: Patients were classified into four groups based on baseline DLCO and residual volume/total lung capacity (RV/TLC) measurements. The annual FEV1 decline rate was greater in patients with low DLCO than in those with normal DLCO, with the greatest decline occurring in patients with low DLCO and normal RV/TLC. RV and RV/TLC declined in patients with high RV/TLC, whereas these increased in patients with normal RV/TLC. DLCO decreased longitudinally in all four groups, with the greatest decline occurring in patients with normal DLCO and normal RV/TLC.CONCLUSIONS: Different subgroups of patients with COPD exhibited distinctive pulmonary function change patterns. Baseline DLCO and RV/TLC may be used as physiological markers to predict long-term changes in pulmonary function.

Twins studies as a model for studies on the interaction between smoking and genetic factors in the development of chronic bronchitis

2009 ◽  
Vol 37 (4) ◽  
pp. 814-818 ◽  
Author(s):  
Magnus Svartengren ◽  
Gunnar Engström ◽  
Martin Anderson ◽  
Jenny Hallberg ◽  
Goutham Edula ◽  
...  
Keyword(s):  
Chronic Bronchitis ◽  
Genetic Factors ◽  
Clinical Investigation ◽  
Heritability Estimate ◽  
Smoking Behaviour ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Diffusion Capacity ◽  
Swedish Twin Registry

Smoking is the main risk factor for COPD (chronic obstructive pulmonary disease) but genetic factors are of importance, since only a subset of smokers develops the disease. Sex differences have been suggested both in disease prevalence and response to environmental exposures. Furthermore, it has been shown that acquisition of ‘addiction’ to smoking is partly genetically mediated. Disease cases and smoking habits were identified in 44919 twins aged >40 years from the Swedish Twin Registry. Disease was defined as self-reported chronic bronchitis or emphysema, or recurrent cough with phlegm. The results showed that chronic bronchitis seems to be more prevalent among females, and that the heritability estimate for chronic bronchitis was a moderate 40% and only 14% of the genetic influences were shared by smoking. In addition, 392 twins have been invited to a clinical investigation to evaluate: (i) to what extent genetic factors contribute to individual differences (variation) in FEV1 (forced expiratory volume in 1 s), vital capacity and DLCO (diffusion capacity), taking sex into consideration, and (ii) whether smoking behaviour and respiratory symptoms influence these estimates.

scholarly journals Prognostic Marker for Severe Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Analysis of Diffusing Capacity of the Lung for Carbon Monoxide (DLCO) and Forced Expiratory Volume in One Second (FEV1)

2020 ◽  
Author(s):  
Juwhan Choi ◽  
Jae Kyeom Sim ◽  
Jee Youn Oh ◽  
Young Seok Lee ◽  
Gyu Young Hur ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Length Of Hospital Stay ◽  
Forced Expiratory Volume ◽  
Curve Analysis ◽  
Chronic Obstructive ◽  
Diffusing Capacity ◽  
Roc Curve Analysis ◽  
Obstructive Pulmonary Disease

Abstract Background: It is important to assess the prognosis and classify patients in chronic obstructive pulmonary disease (COPD) and acute exacerbation of COPD (AECOPD) treatment. Recently, it was suggested that diffusing capacity of the lung for carbon monoxide (DLCO) should be added to multidimensional tools for assessing COPD. This study aimed to compare the DLCO and forced expiratory volume in one second (FEV1) to identify better prognostic factors for admitted patients with AECOPD.Methods: We retrospectively analyzed 342 patients with AECOPD receiving inpatient treatment. We classified 342 severe AECOPD events using DLCO and FEV1. We defined the prognostic factors of severe AECOPD as the length of hospital stay, mortality in hospital, experience of mechanical ventilation, and experience of intensive care unit (ICU) care. We analyzed the prognostic factors by multivariate analysis using logistic regression. In addition, we conducted a correlation analysis and receiver operating characteristic (ROC) curve analysis.Results: In univariate and multivariate analyses, DLCO was shown to predict mortality rate (odds ratio = 4.408; 95% confidence interval, 1.070–18.167; P = 0.040), experience of ventilator (odds ratio = 2.855; 95% confidence interval, 1.216–6.704; P = 0.016) and ICU (odds ratios = 2.685; 95% confidence interval, 1.290–5.590; P = 0.008). However, there was no statistically significant difference in mortality rate when using FEV1 classification (P = 0.075). In the correlation analysis, both DLCO and FEV1 showed a negative correlation with length of hospital stay. The correlation rate was more pronounced in the DLCO (DLCO; B = -0.103, P < 0.001) (FEV1; B = -0.075, P = 0.007). In addition, DLCO showed better predictive ability than FEV1 in ROC curve analysis. The area under the curve (AUC) of DLCO was greater than 0.68 for all prognostic factors, and in contrast, the AUC of FEV1 was less than 0.68.Conclusion: DLCO was likely to be as good as or better prognostic marker than FEV1 in severe AECOPD.

scholarly journals Relationship of spirometric, body plethysmographic, and diffusing capacity parameters to emphysema scores derived from CT scans

2018 ◽  
Vol 16 ◽  
pp. 147997231877542 ◽  
Author(s):  
Kathrin Kahnert ◽  
Bertram Jobst ◽  
Frank Biertz ◽  
Jürgen Biederer ◽  
Henrik Watz ◽  
...  
Keyword(s):  
Forced Expiratory Volume ◽  
Ct Scans ◽  
Chronic Obstructive ◽  
Diffusing Capacity ◽  
Body Plethysmography ◽  
Obstructive Pulmonary Disease ◽  
Predictive Values ◽  
Additional Information ◽  
Intrathoracic Gas Volume ◽  
Gas Volume

Phenotyping of chronic obstructive pulmonary disease (COPD) with computed tomography (CT) is used to distinguish between emphysema- and airway-dominated type. The phenotype is reflected in correlations with lung function measures. Among these, the relative value of body plethysmography has not been quantified. We addressed this question using CT scans retrospectively collected from clinical routine in a large COPD cohort. Three hundred and thirty five patients with baseline data of the German COPD cohort COPD and Systemic Consequences-Comorbidities Network were included. CT scans were primarily evaluated using a qualitative binary emphysema score. The binary score was positive for emphysema in 52.5% of patients, and there were significant differences between the positive/negative groups regarding forced expiratory volume in 1 second (FEV1), FEV1/forced vital capacity (FVC), intrathoracic gas volume (ITGV), residual volume (RV), specific airway resistance (sRaw), transfer coefficient (KCO), transfer factor for carbon monoxide (TLCO), age, pack-years, and body mass index (BMI). Stepwise discriminant analyses revealed the combination of FEV1/FVC, RV, sRaw, and KCO to be significantly related to the binary emphysema score. The additional positive predictive value of body plethysmography, however, was only slightly higher than that of the conventional combination of spirometry and diffusing capacity, which if taken alone also achieved high predictive values, in contrast to body plethysmography. The additional information on the presence of CT-diagnosed emphysema as conferred by body plethysmography appeared to be minor compared to the well-known combination of spirometry and CO diffusing capacity.

RESPIRATORY TUBERCULOSIS AND CHRONIC OBSTRUCTIVE LUNG DISEASE - FEATURES OF THE COMORBIDE STATE

2019 ◽  
Author(s):  
Anna Viktorovna Katicheva ◽  
Nikolai Andreyevich Brazhenko ◽  
Olga Nikolaevna Brazhenko ◽  
Anna Georgievna Chuikova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Rapid Development ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Obstructive Pulmonary Disease ◽  
Diffusion Capacity ◽  
Cardiovascular Pathology ◽  
Systemic Arterial Hypertension

In modern conditions, chronic tobacco intoxication and chronic obstructive pulmonary disease are widespread and affect the health and life expectancy of patients. Among patients with tuberculosis, chronic tobacco intoxication and COPD are also widespread. Against the background of smoking and chronic obstructive pulmonary disease in patients with tuberculosis of the respiratory system, bronchial obstruction, hypoxemia, impaired capillary pulmonary blood flow, and a decrease in the diffusion capacity of the lungs are determined. A comorbid state is accompanied by the development of oxidative stress, systemic inflammation, endothelial dysfunction. Such changes in combination with dyslipidemia contribute to the development of multifocal atherogenesis, systemic arterial hypertension and the rapid development of cardiovascular pathology

scholarly journals Prognostic and functional impact of perioperative LAMA/LABA inhaled therapy in patients with lung cancer and chronic obstructive pulmonary disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoko Azuma ◽  
Atsushi Sano ◽  
Takashi Sakai ◽  
Satoshi Koezuka ◽  
Hajime Otsuka ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Chronic Obstructive Pulmonary Disease ◽  
Postoperative Complications ◽  
Lung Function ◽  
Retrospective Review ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Inhaled Therapy ◽  
Long Acting

Abstract Background Chronic obstructive pulmonary disease (COPD) is an important risk factor for postoperative complications and mortality. To determine the effects of perioperative combination therapy, using a long-acting muscarinic antagonist (LAMA) and a long-acting β2 agonist (LABA), on preoperative lung function, postoperative morbidity and mortality, and long-term outcome in COPD patients. Methods Between January 2005 and October 2019, 130 consecutive patients with newly diagnosed COPD underwent surgery for lung cancer. We conducted a retrospective review of their medical record to evaluate that LAMA/LABA might be an optimal regimen for patients with COPD undergoing surgery for lung cancer. All patients were received perioperative rehabilitation and divided into 3 groups according to the type of perioperative inhaled therapy and management: LAMA/LABA (n = 64), LAMA (n = 23) and rehabilitation only (no bronchodilator) (n = 43). We conducted a retrospective review of their medical records. Results Patients who received preoperative LAMA/LABA therapy showed significant improvement in lung function before surgery (p < 0.001 for both forced expiratory volume in 1 s (FEV1) and percentage of predicted forced expiratory volume in 1 s (FEV1%pred). Compared with patients who received preoperative LAMA therapy, patients with LAMA/LABA therapy had significantly improved lung function (ΔFEV1, LAMA/LABA 223.1 mL vs. LAMA 130.0 mL, ΔFEV1%pred, LAMA/LABA 10.8% vs. LAMA 6.8%; both p < 0.05). Postoperative complications were lower frequent in the LAMA/LABA group than in the LAMA group (p = 0.007). In patients with moderate to severe air flow limitation (n = 61), those who received LAMA/LABA therapy had significantly longer overall survival and disease-free survival compared with the LAMA (p = 0.049, p = 0.026) and rehabilitation-only groups (p = 0.001, p < 0.001). Perioperative LAMA/LABA therapy was also associated with lower recurrence rates (vs. LAMA p = 0.006, vs. rehabilitation-only p = 0.008). Conclusions We believe this treatment combination is optimal for patients with lung cancer and COPD.

scholarly journals Validation of Clinical Characteristics and Effectiveness of Pulmonary Rehabilitation in a COPD Population with Discrepancy between Exercise Tolerance and FEV1

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 53
Author(s):  
Jun Horie ◽  
Koichiro Takahashi ◽  
Shuuichi Shiranita ◽  
Kunihiko Anami ◽  
Shinichiro Hayashi
Keyword(s):  
Gait Speed ◽  
Pulmonary Rehabilitation ◽  
Exercise Tolerance ◽  
Respiratory Illness ◽  
Forced Expiratory Volume ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
St George's Respiratory Questionnaire ◽  
History Of

This study’s objective was to examine the characteristics of patients with chronic obstructive pulmonary disease (COPD) presenting with various exercise tolerance levels. A total of 235 patients with stable COPD were classified into 4 groups: (1) LoFlo + HiEx—patients with a six-minute walking distance (6MWD) ≥350 m and percentage of predicted forced expiratory volume in 1 s (%FEV1.0) <50%; (2) HiFlo + HiEx—patients with a 6MWD ≥350 m and a %FEV1.0 ≥50%; (3) LoFlo + LoEx—patients with a 6MWD < 350 m and %FEV1.0 < 50%; and (4) HiFlo + LoEx—patients with a 6MWD <350 m and %FEV1.0 ≥ 50%. Aspects of physical ability in the HiFlo + LoEx group were significantly lower than those in the HiFlo + HiEx group. The HiFlo + LoEx group was characterized by a history of hospitalization for respiratory illness within the past year, treatment with at-home oxygen therapy, and lacking daily exercise habits. Following three months of pulmonary rehabilitation, the LoFlo + HiEx group significantly improved in the modified Medical Research Council dyspnea score, maximum gait speed, and 6MWD, while the HiFlo + LoEx group significantly improved in the percentage of maximal expiratory pressure, maximum gait speed, 6MWD, incremental shuttle walking distance, and St. George’s Respiratory Questionnaire score. The HiFlo + LoEx group had the greatest effect of three-month pulmonary rehabilitation compared to other groups.

Sign in / Sign up

Export Citation Format

Share Document