H Ben Saad1, L Ben Amor2, S Ben Mdalla2, I Ghannouchi3, M Ben Essghair2, R Sfaxi4, A Garrouche5, N Rouatbi6, S Rouatbi3. 1. Service de physiologie et des explorations fonctionnelles, EPS Farhat Hached, Sousse, Tunisie; Laboratoire de physiologie, faculté de médecine « Ibn Eljazzar » de Sousse, université de Sousse, avenue Mohamed Karoui, 4000 Sousse, Tunisie. Electronic address: helmi.bensaad@rns.tn. 2. Service de physiologie et des explorations fonctionnelles, EPS Farhat Hached, Sousse, Tunisie. 3. Service de physiologie et des explorations fonctionnelles, EPS Farhat Hached, Sousse, Tunisie; Laboratoire de physiologie, faculté de médecine « Ibn Eljazzar » de Sousse, université de Sousse, avenue Mohamed Karoui, 4000 Sousse, Tunisie. 4. Consultation externe de pneumologie, groupement de santé de base, Sousse, Tunisie. 5. Service de pneumologie, EPS Farhat Hached, Sousse, Tunisie. 6. Service de pneumologie, EPS Fattouma Bourguiba, Monastir, Tunisie.
Abstract
INTRODUCTION: Lung hyperinflation (LH) has become a major concern in the management of chronic obstructive pulmonary disease (COPD). MAIN AIM: To evaluate the role of lung volumes in the positive diagnosis of COPD and in the assessment of airway obstruction reversibility. POPULATION AND METHODS: Three hundred and sixty-six male smokers over the age of 35 with more than 40 pack-years exposure were included in the study. Plethysmographic data were determined before/after taking a bronchodilator (BBD, ABD). Applied definitions: airflow obstruction: BBD FEV1/FVC<0.70. LH: BBD residual volume (RV)>upper limit of normal. Expressions of reversibility: Δvariable=(ABD-BBD) values; Δinit%=Δvariable/BBD value and Δref%=Δvariable/reference value. A 12%init and a 0.2L increase in either FEV1 or FVC or a 10%ref or - 300 mL decrease in RV were considered as clinically significant. RESULTS: Over the 85 smokers without airflow obstruction, 68% had LH. In the hyperinflated group (n=314), and compared to changes in FEV1 and FVC, these RV changes detected more respondents (54% for FEV1 and FVC vs. 65% for RV, P=0.002). This was not the case for the group free from LH (n=52) (23% for FEV1 and FVC vs. 35% for RV, P=0.09). In the 58 hyperinflated groups free from airflow obstruction, and compared to changes in FEV1 and FVC, changes in RV detected more respondents (24% for FEV1 and FVC vs. 71% for RV, P=0.0001). CONCLUSION: In heavy smokers, it seems essential to include LH as a criterion for a positive diagnosis of COPD and of reversibility evaluation.
INTRODUCTION: Lung hyperinflation (LH) has become a major concern in the management of chronic obstructive pulmonary disease (COPD). MAIN AIM: To evaluate the role of lung volumes in the positive diagnosis of COPD and in the assessment of airway obstruction reversibility. POPULATION AND METHODS: Three hundred and sixty-six male smokers over the age of 35 with more than 40 pack-years exposure were included in the study. Plethysmographic data were determined before/after taking a bronchodilator (BBD, ABD). Applied definitions: airflow obstruction: BBD FEV1/FVC<0.70. LH: BBD residual volume (RV)>upper limit of normal. Expressions of reversibility: Δvariable=(ABD-BBD) values; Δinit%=Δvariable/BBD value and Δref%=Δvariable/reference value. A 12%init and a 0.2L increase in either FEV1 or FVC or a 10%ref or - 300 mL decrease in RV were considered as clinically significant. RESULTS: Over the 85 smokers without airflow obstruction, 68% had LH. In the hyperinflated group (n=314), and compared to changes in FEV1 and FVC, these RV changes detected more respondents (54% for FEV1 and FVC vs. 65% for RV, P=0.002). This was not the case for the group free from LH (n=52) (23% for FEV1 and FVC vs. 35% for RV, P=0.09). In the 58 hyperinflated groups free from airflow obstruction, and compared to changes in FEV1 and FVC, changes in RV detected more respondents (24% for FEV1 and FVC vs. 71% for RV, P=0.0001). CONCLUSION: In heavy smokers, it seems essential to include LH as a criterion for a positive diagnosis of COPD and of reversibility evaluation.
Authors: Hadhemi Rejeb; Mouna Ben Khelifa; Jihene Ben Abdallah; Sawssan Mrad; Mohamed Ben Rejeb; Abdelaziz Hayouni; Mohamed Benzarti; Khelifa Limem; Mondher Kortas; Sonia Rouatbi; Helmi Ben Saad Journal: Am J Mens Health Date: 2018-08-17
Authors: Sonia Rouatbi; Mohamed Ali Chouchene; Ines Sfaxi; Mohamed Ben Rejeb; Zouhair Tabka; Helmi Ben Saad Journal: Biomed Res Int Date: 2014-06-03 Impact factor: 3.411