Evaluation of Post-Bronchodilator Reversibility in Patient with Chronic Obstructive Pulmonary Disease and Asthma

2020 ◽  
Vol 22 (4) ◽  
pp. 223-227
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Pant
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Disease ◽  
Pulmonary Disease ◽  
Obstructive Lung Disease ◽  
College Teaching ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Recurrent Wheezing ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Obstructive lung disease is a group of disorders comprising Chronic Obstructive Pulmonary Disease (COPD) and asthma. It is one of the most common causes of morbidity and mortality worldwide. COPD is a preventable and treatable disease characterized by persistent respiratory symptoms and airflow limitation, whereas asthma is reversible episodes of recurrent wheezing, cough, breathlessness, and chest tightness. It is sometimes difficult to distinguish COPD from asthma when COPD patients present with significant post-bronchodilator reversibility. Spirometry is the gold standard test to diagnose obstructive airway disease. We carried out a hospital-based cross-sectional study in Nepal Medical College Teaching Hospital from January 2018 to December 2018. One hundred and ninety eight patients who met the inclusion criteria underwent spirometry. Basal and post-bronchodilator FEV1, FVC, FEV1/FVC, and reversibility of FEV1 were measured. The majority of the patients enrolled in the study were males (n=100). The mean age of the patients was 49.3±17.0 years. Most of the patients were above 60 years of age (n=68). Clinical diagnosis of asthma was made in 113 (57%) and COPD in 85 (43%) patients. Post-bronchodilator reversibility was observed in 48 (42%) asthmatic and 19 (22%) COPD patients. Post-bronchodilator reversibility was statistically significant in asthmatic patients (p=0.032). Post-bronchodilator reversibility was observed in COPD patients as well. Therefore, post-bronchodilator reversibility alone may have a limited role in differentiating COPD from bronchial asthma. However, spirometry is mandatory to diagnose a patient with obstructive lung disease.

scholarly journals Underdiagnosis of obstructive lung disease: findings from the French CONSTANCES cohort

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marie-Christine Delmas ◽  
Laetitia Bénézet ◽  
Céline Ribet ◽  
Yuriko Iwatsubo ◽  
Marie Zins ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Disease ◽  
Pulmonary Disease ◽  
Obstructive Lung Disease ◽  
Respiratory Symptoms ◽  
Tobacco Consumption ◽  
Population Based ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Abstract Background The burden of undiagnosed obstructive lung disease (OLD) (mainly asthma and chronic obstructive pulmonary disease) is not fully established, and targets for corrective action are yet to be identified. We assessed the underdiagnosis of OLD and its determinants in France. Methods CONSTANCES is a French population-based cohort of adults aged 18–69 years at inception. We analysed data collected at inclusion in 2013–2014. Undiagnosed OLD was defined as spirometry-confirmed airflow limitation (FEV1/FVC < lower limit of normal) without prior diagnosis of asthma, chronic obstructive pulmonary disease, or bronchiectasis. Multivariate analysis was performed with weighted robust Poisson regression models to estimate the adjusted prevalence ratios (aPR) of undiagnosed OLD. Results Spirometry results were available for 19,398 participants. The prevalence of airflow limitation was 4.6%. Overall, 64.4% of adults with airflow limitation did not report a previous diagnosis of OLD. Individuals with high cumulative tobacco consumption (≥ 10 pack-years) (aPR: 1.72 [1.28–2.32]), without respiratory symptoms (aPR: 1.51 [1.28–1.78]), and with preserved lung function (aPR: 1.21 [1.04–1.41] for a 10-point increase in FEV1% predicted) had a higher risk of being undiagnosed. Half of symptomatic individuals with airflow limitation (45% of those with moderate to severe airflow limitation) were undiagnosed with OLD. Conclusion Underdiagnosis of OLD is very common among French adults, even in patients with respiratory symptoms. Efforts should be made in France to raise awareness about OLD in the general population, improve the detection of respiratory symptoms, and increase the use of spirometry among primary care professionals.

scholarly journals Predictors of co-morbidities in chronic obstructive pulmonary disease patients at a tertiary care centre in north India

2019 ◽  
Vol 7 (11) ◽  
pp. 4154
Author(s):  
Kaushlendra Pratap Narayan ◽  
S. K. Verma ◽  
Surya Kant ◽  
R. A. S. Kushwaha ◽  
Santosh Kumar ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inflammatory Process ◽  
Tertiary Care ◽  
Airflow Limitation ◽  
Pulmonary Vasculature ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Co Morbidity

Background: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease that is characterised by persistent respiratory symptoms and airflow limitation. COPD is characterised by an intense inflammatory process in the airways, parenchyma, and pulmonary vasculature. It is possible in some cases that the inflammatory process may overflow into the systemic circulation, promoting a generalised inflammatory reaction. Patient with COPD often have concomitant chronic illness (co-morbidities). The aim of this study is to know the pattern of co-morbidities in COPD patients.Methods: This study was a cross sectional observational study conducted on 172 COPD patients (IPD and OPD) diagnosed on the basis of GOLD guideline 2017. Co morbidities were diagnosed as per standard defined criteria laid down in the respective guidelines.Results: 55.3% of the patients with COPD had co morbidities. 18/88(20.5%) patients presented with multiple co-morbidities. 49/88, 55.7% COPD patients were affected with cardiac (either only cardiac or had multiple organs affected besides cardiac), the commonest co-morbidity. Amongst cardiac, hypertension and congestive heart failure (CHF) was the commonest (n=19/49, 38.8% each) followed by CAD/CSA/IWMI/IHD/AF. Others were metabolic (n=14/88, 15.9%), GERD (n=13/88, 14.8%), Depression (n=11/88, 12.5%). Less prevalent co-morbidities were Osteoporosis (n=8/88, 9.1%), Lung cancer (n=6/88, 6.8%), Bronchiectasis (n=5/88, 5.6%) and OSA (n=3/88, 3.4%).Conclusions: Urban indwelling, advancing age and duration of illness, presentation with low mood, loss of pleasure/ interest, appetite disturbances and heart burn with relief on taking proton pump inhibitor can be predictors of co-morbidities in COPD patients. Chance of finding co-morbidities may be multifactorial. Thus, it is important to look out for co morbidities in each and every COPD patients.

Increased levels of Nε-(carboxymethyl)lysine in epithelial lining fluid from peripheral airways in patients with chronic obstructive pulmonary disease: a pilot study

2010 ◽  
Vol 119 (3) ◽  
pp. 143-149 ◽  
Author(s):  
Hiroshi Kanazawa ◽  
Toyoki Kodama ◽  
Kazuhisa Asai ◽  
Saeko Matsumura ◽  
Kazuto Hirata
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Epithelial Lining ◽  
Obstructive Pulmonary Disease ◽  
Epithelial Lining Fluid ◽  
Peripheral Airways ◽  
Copd Patients ◽  
Carboxymethyl Lysine

It has been reported that small airway inflammation is closely associated with the severity of airflow limitation in COPD (chronic obstructive pulmonary disease). We tested a new method of measurement of biochemical constituents in ELF (epithelial lining fluid) obtained separately from the central or peripheral airways using a bronchoscopic microsampling technique. The present study was designed to determine the validity of measuring CML [Nε-(carboxymethyl)lysine] levels in ELF for the assessment of small airway inflammation in COPD. Ten non-smokers, ten current smokers and 16 COPD patients were included in the present study. Concentrations of CML, 8-isoprostane and IL-8 (interleukin-8) were measured in ELF separately from the central or peripheral airways. CML levels in central airways did not differ significantly, but were markedly higher in peripheral than in central airways in the three groups. However, CML levels in peripheral airways of COPD patients were significantly higher than those in non-smokers and current smokers. In COPD patients, the CML level in peripheral airways was significantly correlated with FEV1 (forced expiratory volume in 1 s) (r=−0.82, P=0.002) and FEV1/FVC (forced vital capacity) (r=−0.57, P=0.03). Moreover, CML levels in peripheral airways were significantly correlated with levels of both 8-isoprostane (r=0.76, P=0.003) and IL-8 (r=0.67, P=0.01). In conclusion, these findings suggest that elevated levels of CML in ELF from peripheral airways were observed in COPD patients, and this parameter was correlated with the severity of airflow limitation.

scholarly journals Cardiovascular comorbidity in patients with chronic obstructive pulmonary disease: echocardiography changes and their relation to the level of airflow limitation

2019 ◽  
Vol 7 (21) ◽  
pp. 3568-3573
Author(s):  
Daniela Buklioska Ilievska ◽  
Jordan Minov ◽  
Nade Kochovska Kamchevska ◽  
Biljana Prgova Veljanova ◽  
Natasha Petkovikj ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
Pulmonary Disease ◽  
Doppler Echocardiography ◽  
Mean Value ◽  
Airflow Limitation ◽  
Left Ventricular Ejection ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Objective. To compare frequency of echocardiographic changes in patients with chronic obstructive pulmonary disease (COPD) and non-COPD controls and to assess their relation to the level of airflow limitation. Methods. Study population included 120 subjects divided in two groups. Group 1 included 60 patients with COPD (52 male and 8 female, aged 40 to 80 years) initially diagnosed according to the actual recommendations. Group 2 included 60 subjects in whom COPD was excluded serving as a control. The study protocol consisted of completion of a questionnaire , pulmonary evaluation (dyspnea severity assessment, baseline and post-bronchodilator spirometry, gas analyses, and chest X-ray) and two dimensional (2D) Doppler echocardiography. Results. We found significantly higher mean right ventricle end-diastolic dimension (RVEDd) in COPD patients as compared to its dimension in controls (28.0 ± 4.8 vs. 24.4 ± 4.3; P = 0.0000). Pulmonary hypertension (PH) was more frequent in COPD patients than in controls (28.0 ± 4.8 vs. 24.4 ± 4.3; P = 0.0000) showing linear relationship with severity of airflow limitation. The mean value of left ventricular ejection fraction (LVEF%) was significantly lower in COPD patients than its mean value in controls (57.4 ± 6.9% vs. 64.8 ± 2.7; P = 0.0000) with no correlation with severity of airflow limitation.       Conclusion. Frequency of echocardiographic changes in COPD patients was significantly higher as compared to their frequency in controls in the most cases being significantly associated with severity of airflow limitation. Echocardiography enables early, noninvasive, and accurate diagnosis of cardiac changes in COPD patients giving time for early intervention. Key words: airflow limitation, chronic obstructive pulmonary disease, Doppler echocardiography, pulmonary hypertension, ventricular dysfunction.  

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