BACKGROUND: Early identification of patients with COPD and prone to more rapid decline in lung function is of particular interest from both a prognostic and therapeutic point of view. The aim of this study was to identify the clinical, functional and imaging characteristics associated with the rapid FEV(1) decline in COPD. METHODS: Between 2001 and 2005, 131 outpatients with moderate COPD in stable condition under maximum inhaled therapy underwent clinical interview, pulmonary function tests and HRCT imaging of the chest and were followed for at least 3 years. RESULTS: Twenty-six percent of patients had emphysema detected visually using HRCT. The FEV(1) decline was 42 ± 66 mL/y in the total sample, 88 ± 76 mL/y among rapid decliners and 6 ± 54 mL/y among the other patients. In the univariable analysis, the decline of FEV(1) was positively associated with pack-years (p < 0.05), emphysema at HRCT (p < 0.001), RV (p < 0.05), FRC (p < 0.05), FEV(1) (p < 0.01) at baseline and with number of hospitalizations per year (p < 0.05) during the follow-up. Using multivariable analysis, the presence of emphysema proved to be an independent prognostic factor of rapid decline (p = 0.001). When emphysema was replaced by RV, the model still remained significant. CONCLUSIONS: The rapid decline in lung function may be identified by the presence of emphysema at HRCT or increased RV in patients with a long smoking history.
BACKGROUND: Early identification of patients with COPD and prone to more rapid decline in lung function is of particular interest from both a prognostic and therapeutic point of view. The aim of this study was to identify the clinical, functional and imaging characteristics associated with the rapid FEV(1) decline in COPD. METHODS: Between 2001 and 2005, 131 outpatients with moderate COPD in stable condition under maximum inhaled therapy underwent clinical interview, pulmonary function tests and HRCT imaging of the chest and were followed for at least 3 years. RESULTS: Twenty-six percent of patients had emphysema detected visually using HRCT. The FEV(1) decline was 42 ± 66 mL/y in the total sample, 88 ± 76 mL/y among rapid decliners and 6 ± 54 mL/y among the other patients. In the univariable analysis, the decline of FEV(1) was positively associated with pack-years (p < 0.05), emphysema at HRCT (p < 0.001), RV (p < 0.05), FRC (p < 0.05), FEV(1) (p < 0.01) at baseline and with number of hospitalizations per year (p < 0.05) during the follow-up. Using multivariable analysis, the presence of emphysema proved to be an independent prognostic factor of rapid decline (p = 0.001). When emphysema was replaced by RV, the model still remained significant. CONCLUSIONS: The rapid decline in lung function may be identified by the presence of emphysema at HRCT or increased RV in patients with a long smoking history.
Authors: Mona Ali Fouda; Esam Hamad Alhamad; Mohammed Saleh Al-Hajjaj; Shaffi Ahmed Shaik; Ahmad Amer Alboukai; Feisal Abdulla Al-Kassimi Journal: Ann Thorac Med Date: 2017 Apr-Jun Impact factor: 2.219
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Authors: Phuwanat Sakornsakolpat; Dmitry Prokopenko; Brian D Hobbs; Michael H Cho; Maxime Lamontagne; Nicola F Reeve; Anna L Guyatt; Victoria E Jackson; Nick Shrine; Dandi Qiao; Traci M Bartz; Deog Kyeom Kim; Mi Kyeong Lee; Jeanne C Latourelle; Xingnan Li; Jarrett D Morrow; Ma'en Obeidat; Annah B Wyss; Per Bakke; R Graham Barr; Terri H Beaty; Steven A Belinsky; Guy G Brusselle; James D Crapo; Kim de Jong; Dawn L DeMeo; Tasha E Fingerlin; Sina A Gharib; Amund Gulsvik; Ian P Hall; John E Hokanson; Woo Jin Kim; David A Lomas; Stephanie J London; Deborah A Meyers; George T O'Connor; Stephen I Rennard; David A Schwartz; Pawel Sliwinski; David Sparrow; David P Strachan; Ruth Tal-Singer; Yohannes Tesfaigzi; Jørgen Vestbo; Judith M Vonk; Jae-Joon Yim; Xiaobo Zhou; Yohan Bossé; Ani Manichaikul; Lies Lahousse; Edwin K Silverman; H Marike Boezen; Louise V Wain; Martin D Tobin Journal: Nat Genet Date: 2019-02-25 Impact factor: 38.330
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