B Alcázar-Navarrete1, P J Romero-Palacios2, A Ruiz-Sancho3, O Ruiz-Rodriguez4. 1. Neumología, Área Integrada de Gestión de Medicina, Agencia Sanitaria de Poniente Hospital de Alta Resolución de Loja. Granada, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, Spain. Electronic address: balcazar@telefonica.net. 2. Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, Spain. 3. Medicina Interna, ÁreaIntegrada de Gestión de Medicina, AgenciaSanitaria de Poniente. Hospital de Alta Resolución de Loja, Granada, Spain. 4. Neumología, Área Integrada de Gestión de Medicina, Agencia Sanitaria de Poniente Hospital de Alta Resolución de Loja. Granada, Spain.
Abstract
INTRODUCTION: COPD is a highly heterogeneous disease that has a serious impact on affected populations. Patients share some of the features of bronchial asthma, often summarized under the term ACOS (asthma-COPD overlap syndrome). The objective of this study is to evaluate the utility of the measurement of nitric oxide in exhaled air (FENO50) in the diagnosis of COPD phenotypes. MATERIAL AND METHODS: The study comprised cross-sectional observation of patients receiving assistance during a respiratory outpatient visit. Patient data was collected on lung function, FENO, questionnaires scoring CAT®(COPD Assessment Test), and COPD clinical phenotype. RESULTS: 192 patients were studied: 103 with COPD; 16 healthy non-smokers; 30 healthy smokers; and 43 asthmatics. COPD patients were grouped by phenotype: 34 non exacerbators (33.0%); 22 ACOS (21.3%); 13 frequent exacerbators with emphysema (12.6%); and 34 frequent exacerbators with chronic bronchitis (33.0%). ACOS patients showed significantly higher FENO50 values compared to the others after adjustments for confounding factors. FENO50 demonstrated greater diagnostic accuracy than the bronchodilator test (BT) in the diagnosis of ACOS and COPD phenotypes (AUC 0.79 vs 0.74), with an optimal cut-off value of 19 ppb (sensitivity 0.68, specificity 0.75). CONCLUSIONS: Patients with COPD have different levels of FENO50 depending on the COPD phenotype. FENO50 measurement provides better diagnostic accuracy than BT, with an optimal cut-off value of 19 ppb.
INTRODUCTION: COPD is a highly heterogeneous disease that has a serious impact on affected populations. Patients share some of the features of bronchial asthma, often summarized under the term ACOS (asthma-COPD overlap syndrome). The objective of this study is to evaluate the utility of the measurement of nitric oxide in exhaled air (FENO50) in the diagnosis of COPD phenotypes. MATERIAL AND METHODS: The study comprised cross-sectional observation of patients receiving assistance during a respiratory outpatient visit. Patient data was collected on lung function, FENO, questionnaires scoring CAT®(COPD Assessment Test), and COPD clinical phenotype. RESULTS: 192 patients were studied: 103 with COPD; 16 healthy non-smokers; 30 healthy smokers; and 43 asthmatics. COPD patients were grouped by phenotype: 34 non exacerbators (33.0%); 22 ACOS (21.3%); 13 frequent exacerbators with emphysema (12.6%); and 34 frequent exacerbators with chronic bronchitis (33.0%). ACOS patients showed significantly higher FENO50 values compared to the others after adjustments for confounding factors. FENO50 demonstrated greater diagnostic accuracy than the bronchodilator test (BT) in the diagnosis of ACOS and COPD phenotypes (AUC 0.79 vs 0.74), with an optimal cut-off value of 19 ppb (sensitivity 0.68, specificity 0.75). CONCLUSIONS:Patients with COPD have different levels of FENO50 depending on the COPD phenotype. FENO50 measurement provides better diagnostic accuracy than BT, with an optimal cut-off value of 19 ppb.
Authors: Marc Miravitlles; Borja G Cosío; Aurelio Arnedillo; Myriam Calle; Bernardino Alcázar-Navarrete; Cruz González; Cristóbal Esteban; Juan Antonio Trigueros; José Miguel Rodríguez González-Moro; José Antonio Quintano Jiménez; Adolfo Baloira Journal: Respir Res Date: 2017-11-28
Authors: Bernardino Alcázar-Navarrete; Juan Antonio Trigueros; Juan Antonio Riesco; Anna Campuzano; Joselín Pérez Journal: Int J Chron Obstruct Pulmon Dis Date: 2018-04-10