Contributors of the Severity of Airflow Limitation in COPD Patients.
- Author:
Yoonki HONG
1
;
Eun Jin CHAE
;
Joon Beom SEO
;
Ji Hyun LEE
;
Eun Kyung KIM
;
Young Kyung LEE
;
Tae Hyung KIM
;
Woo Jin KIM
;
Jin Hwa LEE
;
Sang Min LEE
;
Sangyeub LEE
;
Seong Yong LIM
;
Tae Rim SHIN
;
Ho Il YOON
;
Seung Soo SHEEN
;
Seung Won RA
;
Jae Seung LEE
;
Jin Won HUH
;
Sang Do LEE
;
Yeon Mok OH
Author Information
- Publication Type:Original Article
- Keywords: Pulmonary Disease, Chronic Obstructive; Forced Expiratory Volumes; Tomography, X-Ray Computed
- MeSH: Aged; Airway Obstruction; Cone-Beam Computed Tomography; Emphysema; Forced Expiratory Volume; Humans; Linear Models; Lung; Pathologic Processes; Physical Examination; Pulmonary Disease, Chronic Obstructive; Smoke; Smoking; Spirometry; Tobacco Products; Tomography, X-Ray Computed; Vital Capacity
- From:Tuberculosis and Respiratory Diseases 2012;72(1):8-14
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Although airway obstruction in chronic obstructive pulmonary disease (COPD) is due to pathologic processes in both the airways and the lung parenchyma, the contribution of these processes, as well as other factors, have not yet been evaluated quantitatively. We therefore quantitatively evaluated the factors contributing to airflow limitation in patients with COPD. METHODS: The 213 COPD patients were aged >45 years, had smoked >10 pack-years of cigarettes, and had a post-bronchodilator forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) <0.7. All patients were evaluated by medical interviews, physical examination, spirometry, bronchodilator reversibility tests, lung volume, and 6-minute walk tests. In addition, volumetric computed tomography (CT) was performed to evaluate airway wall thickness, emphysema severity, and mean lung density ratio at full expiration and inspiration. Multiple linear regression analysis was performed to identify the variables independently associated with FEV1 - the index of the severity of airflow limitation. RESULTS: Multiple linear regression analysis showed that CT measurements of mean lung density ratio (standardized coefficient beta=-0.46; p<0.001), emphysema severity (volume fraction of the lung less than -950 HU at full inspiration; beta=-0.24; p<0.001), and airway wall thickness (mean wall area %; beta=-0.19, p=0.001), as well as current smoking status (beta=-0.14; p=0.009) were independent contributors to FEV1. CONCLUSION: Mean lung density ratio, emphysema severity, and airway wall thickness evaluated by volumetric CT and smoking status could independently contribute to the severity of airflow limitation in patients with COPD.
