Emphysematous phenotype is an independent predictor for frequent exacerbation of chronic obstructive pulmonary disease (COPD)
J. H. Park, S. Sheen, Y. M. Oh, J. B. Seo, K. H. Yoo, J. H. Lee, T. H. Kim, S. Y. Lim, H. I. Yoon, J. S. Lee, S. D. Lee (Suwon, Seoul, Seongnam, Guri, Republic Of Korea; Seoul, Republic Of Moldova)
Source: International Congress 2014 – Phenotyping and monitoring asthma and COPD
Session: Phenotyping and monitoring asthma and COPD
Session type: Oral Presentation
Number: 1692
Disease area: Airway diseases
Abstract Background : Frequent exacerbations function as an important prognosticator in COPD, and emphysema is associated with many co-morbidities and lung function decline. Therefore, we tested the hypothesis that emphysematous phenotype contributes to frequent exacerbations of COPD.Methods : We retrospectively analyzed 380 COPD patients from pulmonary clinics at 16 hospitals in Korea from June 2005 to April 2012. Acute exacerbation was evaluated every three months for a total of one year. The patients were classified and analyzed according to the progression of emphysema. We attempted to search unique features separating frequent exacerbators from non exacerbators.Main Results : As emphysema progressed, FEV₁ and FEV₁/FVC worsened, and lung volume measurements showed features of hyperinflation characterized by lower inspiratory capacity (IC)/ total lung capacity(TLC) and higher residual volume (RV)/TLC (p<0.05).Frequent exacerbators had lower body mass index (BMI) and higher St. George Respiratory Questionnaire (SGRQ) than no exacerbators (p< 0.05). Frequent exacerbators had more hyperinflated lungs (higher TLC and higher RV/TLC), more severe airflow limitation (lower FEV₁ and FEV₁/FVC), lower DLCO , lower serum protein levels and higher emphysema index compared to no exacerbators (p< 0.05). In multiple logistic regression analysis, frequent exacerbators were shown to be independently associated with higher emphysema index, lower serum protein levels, and higher RV/TLC (p< 0.05). Conclusions : Our data show that higher emphysema index, higher RV/TLC, and serum lower protein levels are independent predictors of frequent exacerbations in patients with COPD.
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J. H. Park, S. Sheen, Y. M. Oh, J. B. Seo, K. H. Yoo, J. H. Lee, T. H. Kim, S. Y. Lim, H. I. Yoon, J. S. Lee, S. D. Lee (Suwon, Seoul, Seongnam, Guri, Republic Of Korea; Seoul, Republic Of Moldova). Emphysematous phenotype is an independent predictor for frequent exacerbation of chronic obstructive pulmonary disease (COPD). Eur Respir J 2014; 44: Suppl. 58, 1692
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