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.

scholarly journals Effect of Glucocorticoids Following Application of Adenosine Receptor Blockers in Patients with Chronic Obstructive Bronchitis and Bronchial Asthma

2020 ◽  
Vol 8 (B) ◽  
pp. 597-601
Author(s):  
Driton Shabani ◽  
Lirim Mustafa ◽  
Pellumb Islami ◽  
Ali Iljazi ◽  
Arta Dauti ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Adenosine Receptor ◽  
Specific Resistance ◽  
Chronic Obstructive ◽  
Body Plethysmography ◽  
Obstructive Pulmonary Disease ◽  
Receptor Blockers ◽  
Intrathoracic Gas Volume ◽  
Gas Volume ◽  
Preliminary Application

AIM: The effects of the glucocorticoids (GR) fluticasone and budesonide and a blocker of the adenosine receptor in the treatment of patients with chronic obstructive pulmonary disease (COPD) and bronchial asthma were studied in this work. METHODS: The parameters of lung function were determined with body plethysmography. Airway resistance (Raw) was registered and measured and the intrathoracic gas volume and specific resistance (SRaw) of the airways were also calculated. RESULTS: The results of this study of patients with COPD and bronchial asthma used doxofylline as a blocker of the adenosine receptor. Doxofylline was given orally on 7 consecutive days at home with a dose of 2 × 400 mg orally. Raw and IGTV were then measured, and SRaw was calculated. The results indicated a significant decrease in the airway specific resistance (p < 0.05). On the 8th day, the same patients were given two inhalations with spray fluticasone and budesonide (budesonide, 2 inh × 2 mg; Pulmicort 2 inh × 125 mcg). After the inhalations were given, Raw and IGTV were measured after 5, 15, 30, 60, and 120 min, SRaw was then calculated. CONCLUSION: After the preliminary application of doxofylline, the GRs fluticasone and budesonide have a significant effect (p < 0.01) on the decrease of the airway SRaw. This effect suggests that the blocking effect of the adenosine receptor (p < 0.05) emphasizes the bronchodilation effect of GRs (p < 0.01).

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.

scholarly journals Lung Body Plethysmography: From Functional to Clinical Aspects for Prediction of Quality of Life in Patients with Chronic Pulmonary Obstruction

2019 ◽  
Vol 70 (11) ◽  
pp. 3935-3941
Author(s):  
Roxana Maria Nemes ◽  
Florentina Ligia Furtunescu ◽  
Ioan Sorin Tudorache ◽  
Tudor Harsovescu ◽  
Alexandra Floriana Nemes ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Forced Expiratory Volume ◽  
Normal Weight ◽  
Clinical Aspects ◽  
Chronic Obstructive ◽  
Body Plethysmography ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Number Of Patients

We analyze the lung function using advanced measurement (body plethysmography) and standard measurement (spirometry) in stable COPD (Chronic Obstructive Pulmonary Disease) patients. Subjects and methods: 211 patients with stable COPD (88.6% males) age 61�5 years (mean � standard deviation), exsmokers 78.7%, underwent to: body pletysmography , spirometry, electrocardiography. Parameters obtained: residual volume (RV), forced expiratory volume in 1 second (FEV1), were correlated with different parameters and also for prediction of quality of life in COPD patients. In assessing the quality of life we used the St. George�s Respiratory Questionnaire (SGRQ). According to BMI (body mass index) we classify patients in four groups: 1. underweight ([ 20, n = 34), 2. normal weight (20-24, n = 79), 3. overweight (25-29.9, n = 58), 4. obese ( ]30, n = 40), n = number of patients.

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 Prediction of air trapping or pulmonary hyperinflation by forced spirometry in COPD patients: results from COSYCONET

2020 ◽  
Vol 6 (3) ◽  
pp. 00092-2020
Author(s):  
Peter Alter ◽  
Jan Orszag ◽  
Christina Kellerer ◽  
Kathrin Kahnert ◽  
Tim Speicher ◽  
...  
Keyword(s):  
Prediction Models ◽  
Area Under The Curve ◽  
Chronic Obstructive Lung Disease ◽  
Forced Expiratory Volume ◽  
Response To Therapy ◽  
Chronic Obstructive ◽  
Body Plethysmography ◽  
Air Trapping ◽  
Obstructive Pulmonary Disease ◽  
Predictive Parameters

BackgroundAir trapping and lung hyperinflation are major determinants of prognosis and response to therapy in chronic obstructive pulmonary disease (COPD). They are often determined by body plethysmography, which has limited availability, and so the question arises as to what extent they can be estimated via spirometry.MethodsWe used data from visits 1–5 of the COPD cohort COSYCONET. Predictive parameters were derived from visit 1 data, while visit 2–5 data was used to assess reproducibility. Pooled data then yielded prediction models including sex, age, height, and body mass index as covariates. Hyperinflation was defined as ratio of residual volume (RV) to total lung capacity (TLC) above the upper limit of normal. (ClinicalTrials.gov identifier: NCT01245933).ResultsVisit 1 data from 1988 patients (Global Initiative for Chronic Obstructive Lung Disease grades 1–4, n=187, 847, 766, 188, respectively) were available for analysis (n=1231 males, 757 females; mean±sd age 65.1±8.4 years; forced expiratory volume in 1 s (FEV1) 53.1±18.4 % predicted (% pred); forced vital capacity (FVC) 78.8±18.8 % pred; RV/TLC 0.547±0.107). In total, 7157 datasets were analysed. Among measures of hyperinflation, RV/TLC showed the closest relationship to FEV1 % pred and FVC % pred, which were sufficient for prediction. Their relationship to RV/TLC could be depicted in nomograms. Even when neglecting covariates, hyperinflation was predicted by FEV1 % pred, FVC % pred or their combination with an area under the curve of 0.870, 0.864 and 0.889, respectively.ConclusionsThe degree of air trapping/hyperinflation in terms of RV/TLC can be estimated in a simple manner from forced spirometry, with an accuracy sufficient for inferring the presence of hyperinflation. This may be useful for clinical settings, where body plethysmography is not available.

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 Lung Body Plethysmography: From Functional to Clinical Aspects for Prediction of Quality of Life in Patients with Chronic Pulmonary Obstruction

2019 ◽  
Vol 70 (11) ◽  
pp. 3935-3941
Author(s):  
Roxana Maria Nemes ◽  
Florentina Ligia Furtunescu ◽  
Ioan Sorin Tudorache ◽  
Tudor Harsovescu ◽  
Alexandra Floriana Nemes ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Forced Expiratory Volume ◽  
Normal Weight ◽  
Clinical Aspects ◽  
Chronic Obstructive ◽  
Body Plethysmography ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Number Of Patients

We analyze the lung function using advanced measurement (body plethysmography) and standard measurement (spirometry) in stable COPD (Chronic Obstructive Pulmonary Disease) patients. Subjects and methods: 211 patients with stable COPD (88.6% males) age 61�5 years (mean � standard deviation), exsmokers 78.7%, underwent to: body pletysmography , spirometry, electrocardiography. Parameters obtained: residual volume (RV), forced expiratory volume in 1 second (FEV1), were correlated with different parameters and also for prediction of quality of life in COPD patients. In assessing the quality of life we used the St. George�s Respiratory Questionnaire (SGRQ). According to BMI (body mass index) we classify patients in four groups: 1. underweight ([ 20, n = 34), 2. normal weight (20-24, n = 79), 3. overweight (25-29.9, n = 58), 4. obese ( ]30, n = 40), n = number of patients.

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