Clinical Characteristics of COPD Patients with Tidal Expiratory Flow Limitation

Overview

Journal Int J Chron Obstruct Pulmon Dis

Publisher Dove Medical Press

Specialty Pulmonary Medicine

Date 2017 Jun 6

PMID 28579768

Citations 16

Authors

James Dean

Umme Kolsum

Paul Hitchen

Vandana Gupta

Dave Singh

Affiliations

Soon will be listed here.

Abstract

We have used impulse oscillometry to identify COPD patients with tidal expiratory flow limitation (EFL), which is a measurement related to small airway disease. We report that 37.4% of COPD patients had EFL; these patients had multiple clinical characteristics of more severe disease including lower forced expiratory volume in 1 second values, greater hyperinflation, reduced exercise performance, and increased small airway impairment. We highlight that EFL can be used to identify a subgroup of COPD patients with distinct characteristics associated with small airway disease.

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References

Singh D, Corradi M, Spinola M, Petruzzelli S, Papi A . Extrafine beclometasone diproprionate/formoterol fumarate: a review of its effects in chronic obstructive pulmonary disease. NPJ Prim Care Respir Med. 2016; 26:16030. PMC: 4910970. DOI: 10.1038/npjpcrm.2016.30. View

Aarli B, Calverley P, Jensen R, Eagan T, Bakke P, Hardie J . Variability of within-breath reactance in COPD patients and its association with dyspnoea. Eur Respir J. 2014; 45(3):625-34. DOI: 10.1183/09031936.00051214. View

Jetmalani K, Timmins S, Brown N, Diba C, Berend N, Salome C . Expiratory flow limitation relates to symptoms during COPD exacerbations requiring hospital admission. Int J Chron Obstruct Pulmon Dis. 2015; 10:939-45. PMC: 4437522. DOI: 10.2147/COPD.S78332. View

Agusti A, Bel E, Thomas M, Vogelmeier C, Brusselle G, Holgate S . Treatable traits: toward precision medicine of chronic airway diseases. Eur Respir J. 2016; 47(2):410-9. DOI: 10.1183/13993003.01359-2015. View

Singh D, Roche N, Halpin D, Agusti A, Wedzicha J, Martinez F . Current Controversies in the Pharmacological Treatment of Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2016; 194(5):541-9. DOI: 10.1164/rccm.201606-1179PP. View

MacIntyre N, Crapo R, Viegi G, Johnson D, van der Grinten C, Brusasco V . Standardisation of the single-breath determination of carbon monoxide uptake in the lung. Eur Respir J. 2005; 26(4):720-35. DOI: 10.1183/09031936.05.00034905. View

Miller M, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A . Standardisation of spirometry. Eur Respir J. 2005; 26(2):319-38. DOI: 10.1183/09031936.05.00034805. View

Wanger J, Clausen J, Coates A, Pedersen O, Brusasco V, Burgos F . Standardisation of the measurement of lung volumes. Eur Respir J. 2005; 26(3):511-22. DOI: 10.1183/09031936.05.00035005. View

Bickel S, Popler J, Lesnick B, Eid N . Impulse oscillometry: interpretation and practical applications. Chest. 2014; 146(3):841-847. DOI: 10.1378/chest.13-1875. View

10.

Dellaca R, Santus P, Aliverti A, Stevenson N, Centanni S, Macklem P . Detection of expiratory flow limitation in COPD using the forced oscillation technique. Eur Respir J. 2004; 23(2):232-40. DOI: 10.1183/09031936.04.00046804. View

11.

Gagnon P, Guenette J, Langer D, Laviolette L, Mainguy V, Maltais F . Pathogenesis of hyperinflation in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2014; 9:187-201. PMC: 3933347. DOI: 10.2147/COPD.S38934. View

12.

Hogg J, Chu F, Utokaparch S, Woods R, Elliott W, Buzatu L . The nature of small-airway obstruction in chronic obstructive pulmonary disease. N Engl J Med. 2004; 350(26):2645-53. DOI: 10.1056/NEJMoa032158. View

13.

Thomas M, Decramer M, ODonnell D . No room to breathe: the importance of lung hyperinflation in COPD. Prim Care Respir J. 2013; 22(1):101-11. PMC: 6442765. DOI: 10.4104/pcrj.2013.00025. View

14.

Ravi A, Khurana S, Lemon J, Plumb J, Booth G, Healy L . Increased levels of soluble interleukin-6 receptor and CCL3 in COPD sputum. Respir Res. 2014; 15:103. PMC: 4156958. DOI: 10.1186/s12931-014-0103-4. View

15.

Timmins S, Diba C, Schoeffel R, Salome C, King G, Thamrin C . Changes in oscillatory impedance and nitrogen washout with combination fluticasone/salmeterol therapy in COPD. Respir Med. 2013; 108(2):344-50. DOI: 10.1016/j.rmed.2013.10.004. View