scholarly journals Pulmonary Emphysema Regional Distribution and Extent Assessed by Chest Computed Tomography Is Associated With Pulmonary Function Impairment in Patients With COPD

2021 ◽  
Vol 8 ◽  
Author(s):  
Plácido Gomes ◽  
Hélder Novais e Bastos ◽  
André Carvalho ◽  
André Lobo ◽  
Alan Guimarães ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Lung Volume ◽  
Pulmonary Emphysema ◽  
Regional Distribution ◽  
Airway Disease ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Total Lung Volume ◽  
Emphysema Severity ◽  
Function Impairment

Objective: This study aimed to evaluate how emphysema extent and its regional distribution quantified by chest CT are associated with clinical and functional severity in patients with chronic obstructive pulmonary disease (COPD).Methods/Design: Patients with a post-bronchodilator forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) < 0.70, without any other obstructive airway disease, who presented radiological evidence of emphysema on visual CT inspection were retrospectively enrolled. A Quantitative Lung Imaging (QUALI) system automatically quantified the volume of pulmonary emphysema and adjusted this volume to the measured (EmphCTLV) or predicted total lung volume (TLV) (EmphPLV) and assessed its regional distribution based on an artificial neural network (ANN) trained for this purpose. Additionally, the percentage of lung volume occupied by low-attenuation areas (LAA) was computed by dividing the total volume of regions with attenuation lower or equal to −950 Hounsfield units (HU) by the predicted [LAA (%PLV)] or measured CT lung volume [LAA (%CTLV)]. The LAA was then compared with the QUALI emphysema estimations. The association between emphysema extension and its regional distribution with pulmonary function impairment was then assessed.Results: In this study, 86 patients fulfilled the inclusion criteria. Both EmphCTLV and EmphPLV were significantly lower than the LAA indices independently of emphysema severity. CT-derived TLV significantly increased with emphysema severity (from 6,143 ± 1,295 up to 7,659 ± 1,264 ml from mild to very severe emphysema, p < 0.005) and thus, both EmphCTLV and LAA significantly underestimated emphysema extent when compared with those values adjusted to the predicted lung volume. All CT-derived emphysema indices presented moderate to strong correlations with residual volume (RV) (with correlations ranging from 0.61 to 0.66), total lung capacity (TLC) (from 0.51 to 0.59), and FEV1 (~0.6) and diffusing capacity for carbon monoxide DLCO (~0.6). The values of FEV1 and DLCO were significantly lower, and RV (p < 0.001) and TLC (p < 0.001) were significantly higher with the increasing emphysema extent and when emphysematous areas homogeneously affected the lungs.Conclusions: Emphysema volume must be referred to the predicted and not to the measured lung volume when assessing the CT-derived emphysema extension. Pulmonary function impairment was greater in patients with higher emphysema volumes and with a more homogeneous emphysema distribution. Further studies are still necessary to assess the significance of CTpLV in the clinical and research fields.

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.

The Relative Importance of Clinical, Radiological and Pulmonary Function Variables in Evaluating Asbestosis and Chronic Obstructive Airway Disease in Asbestos Workers

1971 ◽  
Vol 41 (6) ◽  
pp. 569-582 ◽  
Author(s):  
Gillian M. Regan ◽  
Beryl Tagg ◽  
Joan Walford ◽  
M. L. Thomson
Keyword(s):  
Pulmonary Function ◽  
Vital Capacity ◽  
Disease Process ◽  
Principal Component ◽  
Airway Disease ◽  
Forced Expiratory Volume ◽  
Obstructive Airway Disease ◽  
Chronic Obstructive ◽  
Pleural Thickening ◽  
Present Context

1. The relative power of sixteen clinical, radiological and pulmonary function variables for evaluating asbestosis and chronic osbtructive airway disease has been assessed by principal component analysis of the data from a survey of 201 asbestos workers. 2. A decrease in the transfer factor (diffusing capacity) for carbon monoxide followed by a decrease in the vital capacity had the greatest power to measure the severity of both types of disease but had little ability to distinguish between the two. 3. In decreasing order of potency, the best indicators for distinguishing between asbestosis and obstructive airway disease were forced expiratory volume as a proportion of vital capacity, phlegm, radiological pleural thickening, cough and finger clubbing. Low values in FEV/VC and high values in phlegm and cough indicated obstructive airway disease: high values of pleural thickening and finger clubbing indicated asbestosis in the present context. 4. The analysis also provided numerical scores for each individual that could be plotted on a two-dimensional diagram. Orientation along one axis showed the degree of involvement of individuals by lung disease, whereas separation along the other axis depended on the nature of the disease process, asbestosis and obstructive airway disease in this instance.

scholarly journals Dietary and supplemental antioxidant and anti-inflammatory nutrient intakes and pulmonary function

2013 ◽  
Vol 17 (9) ◽  
pp. 2081-2086 ◽  
Author(s):  
Tze Pin Ng ◽  
Mathew Niti ◽  
Keng Bee Yap ◽  
Wan Cheng Tan
Keyword(s):  
Pulmonary Function ◽  
Fruits And Vegetables ◽  
Dairy Product ◽  
Population Based ◽  
Cross Sectional Study ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Pulmonary Risk ◽  
Anti Inflammatory

AbstractObjectiveA limited but growing body of evidence supports a significant role of antioxidant and anti-inflammatory micronutrients in pulmonary health. We investigated the associations of dietary and supplemental intakes of vitamins A, C, E and D, Se and n-3 PUFA with pulmonary function in a population-based study.DesignPopulation-based, cross-sectional study and data analysis of fruits and vegetables, dairy products and fish, vitamins A, C, E and D, Se and n-3 PUFA supplemental intakes, pulmonary risk factors and spirometry.SubjectsChinese older adults (n 2478) aged 55 years and above in the Singapore Longitudinal Ageing Studies.ResultsIn multiple regression models that controlled simultaneously for gender, age, height, smoking, occupational exposure and history of asthma/chronic obstructive pulmonary disease, BMI, physical activity, and in the presence of other nutrient variables, daily supplementary vitamins A/C/E (b = 0·044, se = 0·022, P = 0·04), dietary fish intake at least thrice weekly (b = 0·058, se = 0·016, P < 0·0001) and daily supplementary n-3 PUFA (b = 0·068, se = 0·032, P = 0·034) were individually associated with forced expiratory volume in the first second. Supplemental n-3 PUFA was also positively associated with forced vital capacity (b = 0·091, se = 0·045, P = 0·045). No significant association with daily dairy product intake, vitamin D or Se supplements was observed.ConclusionsThe findings support the roles of antioxidant vitamins and n-3 PUFA in the pulmonary health of older persons.

scholarly journals Airway to Lung Volume Ratio on CT is Associated with Pulmonary Function Transition from Obstructive to Restrictive Pattern in Obesity

2022 ◽  
Author(s):  
Xin Yu ◽  
Ming-Hui Zhang ◽  
Yan-Hao Huang ◽  
Yu Deng ◽  
You-Zhen Feng ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Lung Volume ◽  
Volume Ratio ◽  
Lung Ventilation ◽  
Forced Expiratory Volume ◽  
Obese Adults ◽  
Obese Adolescents ◽  
Wall Area ◽  
Adolescents And Adults ◽  
Airway Tree

Abstract Background: Obesity is associated with excessive airway collapse and reduced lung volume; it is unknown whether it affects airway-lung interactions. We sought to compare the airway tree to lung volume ratio, assessed by CT, in obese individuals with and without ventilation disorders.Methods: Participants underwent inspiratory chest CT and pulmonary function. The percentage ratio of the whole airway tree to lung volume, automatically segmented via deep learning, was defined as CT airway volume percent (AWV%). Total airway count (TAC), airway wall area percent (WA%), and other CT indexes were also measured. Results: We evaluated 88 participants including adolescents(age: 14-18, n= 12) and adults (age: 19-25, n= 17; age: 26-35, n= 39; age> 35, n= 20). Obese adolescents had higher forced vital capacity (FVC) (P = 0.001) and lower AWV% (P = 0.008) than obese adults (age >35). Among obese adults, participants with restrictive disorders had larger AWV% (P < 0.001) and those with obstructive disorders showed smaller AWV% (P < 0.001) compared to participants with normal ventilation. AWV% was positively correlated with age and forced expiratory volume in 1 second (FEV1)/FVC and adversely related to FVC (P< 0.05 for all), and in multivariate models, AWV% independently predicted FEV1/FVC (R2 = 0.49, P < 0.001) and FVC (R2 = 0.60, P < 0.001).Conclusion: Transitions in lung function patterns between obese adolescents and adults are associated with airway to lung ratios. The obesity-induced disproportion between the airway tree and lung volume may adversely affect and complicate lung ventilation.

Physical Signs in Childhood Asthma

PEDIATRICS ◽  
1976 ◽  
Vol 58 (4) ◽  
pp. 537-541
Author(s):  
J. O. O. Commey ◽  
Henry Levison
Keyword(s):  
Pulmonary Function ◽  
Airway Obstruction ◽  
Pulmonary Function Tests ◽  
Severe Disease ◽  
Airway Disease ◽  
Chronic Obstructive ◽  
Scalene Muscle ◽  
Lung Capacity ◽  
Residual Capacity ◽  
Severe Airway Obstruction

In 62 children with bronchial asthma, the presence of subjective dyspnea and wheeze, and some physical signs commonly associated with chronic obstructive airway disease in older patients, were compared with results of routine pulmonary function tests. Overall, airway resistance and the relationships of residual volume and functional residual capacity to total lung capacity were increased and other measurements of pulmonary function were moderately decreased. The time-honored subjective dyspnea, wheeze, rhonchi, and prolonged expiration were least useful as indices of severity of disease. Most of the patients, particularly those in whom laboratory testing revealed marked impairment, had notable rhonchi, prolonged expiration, scalene muscle and sternocleidomastoid contraction, and supraclavicular indrawing. Only sternocleidomastoid contraction and supraclavicular indrawing clearly correlated with the severity of airway obstruction. A call is made for a search for these useful signs, whose presence may be the only clue to moderately severe disease; however, their absence does not guarantee absence of severe airway obstruction.

COPD – Stellenwert der Lungenfunktionsanalyse in Diagnostik und Therapie

2018 ◽  
Vol 143 (08) ◽  
pp. 593-596 ◽  
Author(s):  
Wolfram Windisch ◽  
Carl Criée
Keyword(s):  
Pulmonary Function ◽  
Airway Obstruction ◽  
Pulmonary Emphysema ◽  
Pulmonary Function Testing ◽  
Exclusion Criterion ◽  
Chronic Obstructive ◽  
Pharmaceutical Treatment ◽  
Lung Hyperinflation ◽  
Function Testing

AbstractPulmonary function testing is essential for diagnosis and treatment-guidance of chronic obstructive pulmonary disease (COPD). Airway obstruction as assessed by spirometry should follow the reference-values provided by the Global Lung Initiative (GLI) of the European Respiratory Society (ERS). In addition, lung function testing should also include the assessment of lung hyperinflation and pulmonary emphysema by full-body plethysmography and determination of diffusion capacity. This is important since both, lung hyperinflation and pulmonary emphysema, can present without existing airway obstruction. Even though this formally excludes the diagnosis of COPD, these entities still belong to this disease complex. However, strictly speaking, pharmaceutical treatment is valid only for those patients with co-existing airway obstruction according to Global Lung Initiative for Chronic Obstructive Lung Disease (GOLD) criteria – since the absence of airway obstruction serves as exclusion criterion in nearly all randomized controlled trials. Nevertheless, progressive symptoms still require detailed pulmonary function testing for the guidance of non-pharmaceutical treatment – such as endoscopic or surgical lung volume reduction, long-term oxygen therapy, long-term non-invasive ventilation, and lung transplantation.

scholarly journals Predictive Modelling of Lung Function using Emphysematous Density Distribution

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kuo-Lung Lor ◽  
Cheng-Pei Liu ◽  
Yeun-Chung Chang ◽  
Chong-Jen Yu ◽  
Cheng-Yi Wang ◽  
...  
Keyword(s):  
Lung Function ◽  
Predictive Model ◽  
Lung Volume ◽  
Model Fitting ◽  
Chronic Obstructive Lung Disease ◽  
Correlation Study ◽  
Forced Expiratory Volume ◽  
Airflow Limitation ◽  
Normal Lung ◽  
Chronic Obstructive

AbstractTarget lung tissue selection remains a challenging task to perform for treating severe emphysema with lung volume reduction (LVR). In order to target the treatment candidate, the percentage of low attenuation volume (LAV%) representing the proportion of emphysema volume to whole lung volume is measured using computed tomography (CT) images. Although LAV% have shown to have a correlation with lung function in patients with chronic obstructive pulmonary disease (COPD), similar measurements of LAV% in whole lung or lobes may have large variations in lung function due to emphysema heterogeneity. The functional information of regional emphysema destruction is required for supporting the choice of optimal target. The purpose of this study is to develop an emphysema heterogeneity descriptor for the three-dimensional emphysematous bullae according to the size variations of emphysematous density (ED) and their spatial distribution. The second purpose is to derive a predictive model of airflow limitation based on the regional emphysema heterogeneity. Deriving the bullous representation and grouping them into four scales in the upper and lower lobes, a predictive model is computed using the linear model fitting to estimate the severity of lung function. A total of 99 subjects, 87 patients with mild to very severe COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I~IV) and 12 control participants with normal lung functions (forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) > 0.7) were evaluated. The final model was trained with stratified cross-validation on randomly selected 75% of the dataset (n = 76) and tested on the remaining dataset (n = 23). The dispersed cases of LAV% inconsistent with their lung function outcome were evaluated, and the correlation study suggests that comparing to LAV of larger bullae, the widely spread smaller bullae with equivalent LAV has a larger impact on lung function. The testing dataset has the correlation of r = −0.76 (p < 0.01) between the whole lung LAV% and FEV1/FVC, whereas using two ED % of scales and location-dependent variables to predict the emphysema-associated FEV1/FVC, the results shows their correlation of 0.82 (p < 0.001) with clinical FEV1/FVC.

scholarly journals Clinical observation of the use of portable pulmonary function test trainer in patients with stable COPD

2019 ◽  
Vol 02 (04) ◽  
pp. 185-191
Author(s):  
Yuhua Wu ◽  
Jian Zhou ◽  
Mengyu Ma ◽  
Jing Xie ◽  
Ahong Wang ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Daily Living ◽  
Comparison Group ◽  
Psychological Symptoms ◽  
Social Activity ◽  
Intervention Group ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Clinical Effects ◽  
Obstructive Pulmonary Disease

Objective: To investigate the clinical effects of the use of portable pulmonary function tester in patients with stable Chronic Obstructive Pulmonary Disease (COPD). Methods: A total of 80 patients with stable COPD were enrolled in our hospital from March 2018 to March 2019. They were divided into two groups according to different treatment methods. The comparison group was used for routine pulmonary function training, and the intervention group was trained for Portable Pulmonary Function Training and Test Device (PPFTTD). Comparison was made of forced expiratory volume in one second/forced vital capacity (FEV1/FVC), measured/predicted value of the first second forced expiratory volume (FEV1 measured/predicted value), measured/predicted value of maximal voluntary ventilation per minute between the two groups. Quality of life (QOL) scores such as daily living ability, social activity, depressive psychological symptoms, and anxiety psychological symptoms were measured. Results: The FEV1/FVC value, measured/predicted value of FEV1 and MVV of intervention group were higher than those in the comparison group ([Formula: see text]). QOL scores, such as daily living ability, social activity, depression psychological symptoms, and anxiety psychological symptoms in the intervention group, were lower than those in the comparison group ([Formula: see text]). Conclusion: In the treatment of stable COPD, the use of portable pulmonary function tester is significant, and it should be widely promoted and applied in clinical practice.

scholarly journals Treatable traits in an English cohort: Prevalence and predictors of future decline in lung function and quality of life in COPD

2021 ◽  
pp. 00934-2020
Author(s):  
Muhammad Rehan Sarwar ◽  
Vanessa Marie McDonald ◽  
Michael John Abramson ◽  
Eldho Paul ◽  
Johnson George
Keyword(s):  
Quality Of Life ◽  
Lung Function ◽  
Precision Medicine ◽  
Airway Disease ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Lifestyle Risk Factors ◽  
The Core

Background“Treatable traits (TTs)” is a precision medicine approach for facilitating multidimensional assessment of every patient with chronic airway disease to determine the core traits associated with disease outcomes, where targeted treatments are applied.ObjectivesTo determine the prevalence of TTs in chronic obstructive pulmonary disease (COPD) and which traits predict future decline in lung function and quality of life (QoL).MethodsA 4 year longitudinal evaluation was conducted using data from 3726 participants in the English Longitudinal Study of Ageing (ELSA). TTs were identified based on published recommendations. Traits that predicted decline in lung function and QoL were analysed using generalised estimating equations.ResultsOverall, 21 TTs, including pulmonary (n=5), extra-pulmonary (n=13) and behavioural/lifestyle risk-factors (n=3) were identified. In multivariate analyses, traits of chronic bronchitis (β=−0.186; 95%CI=−0.290 to −0.082), breathlessness (β=−0.093; 95%CI=−0.164 to −0.022), underweight (β=−0.216; 95%CI=−0.373 to −0.058), sarcopaenia (β=−0.162; 95%CI=−0.262 to −0.061), and current smoking (β=−0.228; 95%CI=−0.304 to −0.153), predicted decline in forced expiratory volume in 1 s (FEV1). Of the seven traits that predicted decline in QoL, depression (β=−7.19; 95%CI=−8.81 to −5.57) and poor family and social support (β=−5.12; 95%CI=−6.65 to −3.59) were the strongest.ConclusionThe core TTs of COPD associated with a decline in lung function and QoL were identified. Targeting these impactful traits and individualised treatment using a precision medicine approach may improve outcomes in people with COPD.

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