scholarly journals Determinants of Pulmonary Emphysema Severity in Taiwanese Patients with Chronic Obstructive Pulmonary Disease: An Integrated Epigenomic and Air Pollutant Analysis

Biomedicines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1833
Author(s):  
Sheng-Ming Wu ◽  
Wei-Lun Sun ◽  
Kang-Yun Lee ◽  
Cheng-Wei Lin ◽  
Po-Hao Feng ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Air Pollutant ◽  
Integrated Analysis ◽  
Chronic Obstructive ◽  
Disease Course ◽  
Variable Model ◽  
Obstructive Pulmonary Disease ◽  
Low Bmi

Background: Chronic obstructive pulmonary disease (COPD) continues to pose a therapeutic challenge. This may be connected with its nosological heterogeneity, broad symptomatology spectrum, varying disease course, and therapy response. The last three decades has been characterized by increased understanding of the pathobiology of COPD, with associated advances in diagnostic and therapeutic modalities; however, the identification of pathognomonic biomarkers that determine disease severity, affect disease course, predict clinical outcome, and inform therapeutic strategy remains a work in progress. Objectives: Hypothesizing that a multi-variable model rather than single variable model may be more pathognomonic of COPD emphysema (COPD-E), the present study explored for disease-associated determinants of disease severity, and treatment success in Taiwanese patients with COPD-E. Methods: The present single-center, prospective, non-randomized study enrolled 125 patients with COPD and 43 healthy subjects between March 2015 and February 2021. Adopting a multimodal approach, including bioinformatics-aided analyses and geospatial modeling, we performed an integrated analysis of selected epigenetic, clinicopathological, geospatial, and air pollutant variables, coupled with correlative analyses of time-phased changes in pulmonary function indices and COPD-E severity. Results: Our COPD cohort consisted of 10 non-, 57 current-, and 58 ex-smokers (median age = 69 ± 7.76 years). Based on the percentages of low attenuation area below − 950 Hounsfield units (%LAA-950insp), 36 had mild or no emphysema (%LAA-950insp < 6), 22 were moderate emphysema cases (6 ≤ %LAA-950insp < 14), and 9 presented with severe emphysema (%LAA-950insp ≥ 14). We found that BMI, lnc-IL7R, PM2.5, PM10, and SO2 were differentially associated with disease severity, and are highly-specific predictors of COPD progression. Per geospatial levels, areas with high BMI and lnc-IL7R but low PM2.5, PM10, and SO2 were associated with fewer and ameliorated COPD cases, while high PM2.5, PM10, and SO2 but low BMI and lnc-IL7R characterized places with more COPD cases and indicated exacerbation. The prediction pentad effectively differentiates patients with mild/no COPD from moderate/severe COPD cases, (mean AUC = 0.714) and exhibited very high stratification precision (mean AUC = 0.939). Conclusion: Combined BMI, lnc-IL7R, PM2.5, PM10, and SO2 levels are optimal classifiers for accurate patient stratification and management triage for COPD in Taiwan. Low BMI, and lnc-IL7R, with concomitant high PM2.5, PM10, and SO2 levels is pathognomonic of exacerbated/aggravated COPD in Taiwan.

Inspiratory muscle strength in chronic obstructive pulmonary disease depending on disease severity

2007 ◽  
Vol 113 (5) ◽  
pp. 243-249 ◽  
Author(s):  
Hans-Joachim Kabitz ◽  
Stephan Walterspacher ◽  
David Walker ◽  
Wolfram Windisch
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Muscle Strength ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Inspiratory Muscle ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Inspiratory Muscle Strength

Staging criteria for COPD (chronic obstructive pulmonary disease) include symptoms and lung function parameters, but the role of reduced inspiratory muscle strength related to disease severity remains unclear. Therefore the present study tested whether inspiratory muscle strength is reduced in COPD and is related to disease severity according to GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria and assessed its clinical impact. PImax (maximal inspiratory mouth occlusion pressure), SnPna (sniff nasal pressure) and TwPmo (twitch mouth pressure) following bilateral anterior magnetic phrenic nerve stimulation were assessed in 33 COPD patients (8 GOLD0, 6 GOLDI, 6 GOLDII, 7 GOLDIII and 6 GOLDIV) and in 28 matched controls. Furthermore, all participants performed a standardized 6 min walking test. In comparison with controls, PImax (11.6±2.5 compared with 7.3±3.0 kPa; P<0.001), SnPna (9.7±2.5 compared with 6.9±3.3 kPa; P<0.001) and TwPmo (1.6±0.6 compared with 0.8±0.4 kPa; P<0.001) were markedly lower in COPD patients. TwPmo decreased with increasing COPD stage. TwPmo was correlated with walking distance (r=0.75; P<0.001), dyspnoea (r=−0.61; P<0.001) and blood gas values following exercise (r>0.57; P<0.001). Inspiratory muscle strength, as reliably assessed by TwPmo, decreased with increasing severity of COPD and should be considered as an important factor in rating disease severity and to reflect burden in COPD.

A Correlational study on quality of life and disease severity among Chronic Obstructive Pulmonary Disease (COPD) clients attending a pulmonary Medicine OPD of a Tertiary care hospital, Kolkata

2021 ◽  
pp. 528-532
Author(s):  
Uma Rani Adhikari ◽  
Soma Roy
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Tertiary Care ◽  
Chronic Obstructive ◽  
Pulmonary Medicine ◽  
Care Hospital ◽  
Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is recently the most common chronic lung disease and presents a serious medical, economic, and social problem for people. A correlational survey research was adopted to identify relationship between quality of life and disease severity among Chronic Obstructive Pulmonary Disease (COPD) clients attending Pulmonary Medicine OPD in a selected hospital, Kolkata with the objectives to assess the quality of life of Chronic Obstructive Pulmonary Disease (COPD) clients and to find out correlation between disease severity and quality of life among Chronic Obstructive Pulmonary Disease (COPD) clients. Purposive sampling technique was adapted to select 138 Chronic Obstructive Pulmonary Disease (COPD) clients attending Pulmonary Medicine OPD in a tertiary care hospital, Kolkata. The structured interview schedule was used to collect on demographic data and standardized WHO QOL BREF tool was used to assess Quality of Life. Standardized GOLD criteria were used to assess disease severity of COPD clients. Reliability of the demographic data collection tool was established by inter- rater method and r was 0.77. All the tools were tried out before final data collection. The finding of the study revealed statistically non-significant relationship between all the domain of QOL and disease severity of COPD patients. Total Quality of Life score is also not significantly related with COPD Disease severity score. The study results also showed that QOL is not associated with sociodemographic characteristics. The study concluded that, there is no correlation between quality of life and disease severity.

scholarly journals Fatigue and multidimensional disease severity in chronic obstructive pulmonary disease

2010 ◽  
Vol 5 ◽  
Author(s):  
Deniz Inal-Ince ◽  
Sema Savci ◽  
Melda Saglam ◽  
Ebru Calik ◽  
Hulya Arikan ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Airflow Obstruction ◽  
Muscle Endurance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Bode Index ◽  
Peripheral Muscle ◽  
St George's Respiratory Questionnaire

Background and aims: Fatigue is associated with longitudinal ratings of health in patients with chronic obstructive pulmonary disease (COPD). Although the degree of airflow obstruction is often used to grade disease severity in patients with COPD, multidimensional grading systems have recently been developed. The aim of this study was to investigate the relationship between perceived and actual fatigue level and multidimensional disease severity in patients with COPD. Materials and methods: Twenty-two patients with COPD (aged 52-74 years) took part in the study. Multidimensional disease severity was measured using the SAFE and BODE indices. Perceived fatigue was assessed using the Fatigue Severity Scale (FSS) and the Fatigue Impact Scale (FIS). Peripheral muscle endurance was evaluated using the number of sit-ups, squats, and modified push-ups that each patient could do. Results: Thirteen patients (59%) had severe fatigue, and their St George’s Respiratory Questionnaire scores were significantly higher (p < 0.05). The SAFE index score was significantly correlated with the number of sit-ups, number of squats, FSS score and FIS score (p < 0.05). The BODE index was signif- icantly associated with the numbers of sit-ups, squats and modified push-ups, and with the FSS and FIS scores (p < 0.05). Conclusions: Peripheral muscle endurance and fatigue perception in patients with COPD was related to multidimensional disease severity measured with both the SAFE and BODE indices. Improvements in perceived and actual fatigue levels may positively affect multidimensional disease severity and health status in COPD patients. Further research is needed to investigate the effects of fatigue perception and exercise training on patients with different stages of multidimensional COPD severity.

scholarly journals Association of Anthropometric Indexes With Disease Severity in Male Patients With Chronic Obstructive Pulmonary Disease in Qazvin, Iran

2018 ◽  
Vol 12 (4) ◽  
pp. 1023-1028 ◽  
Author(s):  
Ramin Sami ◽  
Raheleh Sadegh ◽  
Neda Esmailzadehha ◽  
Sanaz Mortazian ◽  
Masoomeh Nazem ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Stage Iv ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Gold Stage ◽  
Increased Risk ◽  
Anthropometric Indexes ◽  
Male Patients

Malnutrition is one of the most important factors that lead to lower quality of life in patients suffering from chronic obstructive pulmonary disease (COPD). There are several methods for assessing malnutrition including anthropometric indexes. The aim of this study was to determine the association of anthropometric indexes with disease severity in male patients with COPD in Qazvin, Iran. This cross-sectional study was conducted on 72 male patients with COPD in Qazvin, Iran, from May to December 2014. Spirometry was performed for all participants. Disease severity was determined using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline. Body mass index (BMI), mid-arm muscle circumference (MAMC), and triceps skinfold thickness (TSF) were measured. MAMC and TSF were categorized into three subgroups as <25th P, between 25th P and 75th P, and >75th P (Where P is the abbreviation for percentile.). Data were analyzed using ANOVA and logistic regression analysis. Mean age was 60.23 ± 11.39 years. Mean BMI was 23.23 ± 4.42 Kg/m2, mean MAMC was 28.34 ± 3.72 cm2, and mean TSF was 10.15 ± 6.03 mm. Mean BMI and MAMC in the GOLD stage IV were significantly lower than other stages. Of 72, 18.1% were underweight while 6.9% were obese. The GOLD stage IV was associated with 16 times increased risk of underweight and nine times increased risk of MAMC < 25th P. Disease severity was associated with BMI and MAMC as indexes of malnutrition in patients with COPD in the present study. The GOLD stage IV was associated with increased risk of underweight and low MAMC.

scholarly journals Computed tomography-derived area and density of pectoralis muscle associated disease severity and longitudinal changes in chronic obstructive pulmonary disease: a case control study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
So Hyeon Bak ◽  
Sung Ok Kwon ◽  
Seon-Sook Han ◽  
Woo Jin Kim
Keyword(s):  
Computed Tomography ◽  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Pulmonary Function ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Chronic Obstructive ◽  
Pectoralis Muscle ◽  
Obstructive Pulmonary Disease ◽  
Longitudinal Changes

Abstract Background Muscle wasting is associated with prognosis in patients with chronic obstructive pulmonary disease (COPD). The cross-sectional area of skeletal muscles on computed tomography (CT) could serve as a method to evaluate body composition. The present study aimed to determine the ability of CT-derived pectoralis muscle area (PMA) and pectoralis muscle density (PMD) to determine the severity of COPD and change in longitudinal pulmonary function in patients with COPD. Methods A total of 293 participants were enrolled in this study, a whom 222 had undergone at least two spirometry measurements within 3 years after baseline data acquisition. PMA and PMD were measured from a single axial slice of chest CT above the aortic arch at baseline. The emphysema index and bronchial wall thickness were quantitatively assessed in all scans. The generalized linear model was used to determine the correlation between PMA and PMD measurements and pulmonary function. Results PMA and PMD were significantly associated with baseline lung function and the severity of emphysema (P < 0.05). Patients with the lowest PMA and PMD exhibited significantly more severe airflow obstruction (β = − 0.06; 95% confidence interval: − 0.09 to − 0.03]. PMA was statistically associated with COPD assessment test (CAT) score (P = 0.033). However, PMD did not exhibit statistically significant correlation with either CAT scores or modified Medical Research Council scores (P > 0.05). Furthermore, neither PMA nor PMD were associated with changes in forced expiratory volume in 1 s over a 3-year periods. Conclusions CT-derived features of the pectoralis muscle may be helpful in predicting disease severity in patients with COPD, but are not necessarily associated with longitudinal changes in lung function.

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