Phenotyping emphysema - are there gender aspects?

Introduction: The German COPD guideline indicates an endoscopic lung volume reduction with RV≥175% and FEV1≤45%. When applying these criteria though, the quantitative CT analysis identifies a number of false negative and false positive patients by their low-attenuation volume (LAV), which provides information on the level of emphysema destruction.Aims and Objectives: The study aim was to investigate the correlation between lung functional and morphologic criteria of emphysema in COPD patients.Methods: We retrospectively analyzed the CT data of 112 patients (COPD I-IV, 29% female, 71% male) using MeVisPULMO 3D software and compared the LAV with lung function testing results. The presence of an LAV≥20% was considered as a destruction level confirmative of emphysema. We calculated correlation coefficients and performed a receiver operating characteristic analysis.Results: While we found significant correlations between RV (Spearman’s rho =0.377, P=0.001) and FEV1 (=-0.344, P=0.002) with LAV% for male patients, the correlations were not significant in women (RV: P=0.146, FEV1: P=0.150). For the female patients, the single breath diffusing capacity of the lungs for carbon monoxide corrected for hemoglobin (DLCOcSB) had the strongest correlation with LAV% (=-0.731, P
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Monitoring airway disease Source Type: research

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Conclusions: Inflammatory pathways associated with pulmonary dysfunction in PLWH suggest multifaceted immune dysregulation involved in different phenotypes of pulmonary dysfunction with a potential specific contribution of the Th17 pathway to airway obstruction in PLWH. Identification of these associations may help in development of treatments that could alter the course of the disease.
Source: JAIDS Journal of Acquired Immune Deficiency Syndromes - Category: Infectious Diseases Tags: Translational Research Source Type: research
Abstract BACKGROUND: Diffusing capacity of the lung for carbon monoxide (DLCO) is inconsistently obtained in patients with chronic obstructive pulmonary disease (COPD) and the added benefit of DLCO testing beyond more common tools is unknown. OBJECTIVE: To determine whether lower DLCO is associated with increased COPD morbidity independent of spirometry and CT emphysema. METHODS: Data for 1806 COPD participants from the COPDGene 5-year visit were analyzed, including pulmonary function testing, quality of life, symptoms, exercise performance, and exacerbation rates. DLCO % predicted was primarily analyzed...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
We describe a 66‐year‐old man with severe chronic obstructive pulmonary disease (COPD) who faile d assessments for BLVR because of the inability to perform the carbon monoxide diffusion test but subsequently had EBV deployed to his right upper lobe bronchi for persistent air leak complicating a spontaneous pneumothorax. Afterwards, there was subjective improvement in breathlessness, exercise ca pacity, and reduced frequency of exacerbations requiring hospitalization. Lung function parameters showed marked improvement. This case suggests that patients with compatible spirometric lung volume and computed tomography findi...
Source: Respirology Case Reports - Category: Respiratory Medicine Authors: Tags: Case Report Source Type: research
CONCLUSION: Few patients with COPD received palliative care, similar to national trends. Initial outpatient palliative contact had the longest duration of care and death in the preferred home environment. The extent of emphysema (DLCO reduction) and more frequent disease exacerbations identified in patients were more likely to receive palliative care. Our study begins to define the benefits of palliative care in advanced COPD and confirms underutilization in the years before death, where a prolonged impact on the quality of life may be realized. PMID: 31262230 [PubMed - as supplied by publisher]
Source: Journal of Palliative Care - Category: Palliative Care Tags: J Palliat Care Source Type: research
Abstract Diffusing capacity of carbon monoxide (DLCO) is a widely used pulmonary function test in clinical practice and a particularly useful measure in assessing patients with COPD. We hypothesized that elucidating genetic determinants of DLCO could lead to better understanding of the genetic architecture of COPD. We estimated the heritability of DLCO using common genetic variants and performed genome-wide association analyses in four cohorts enriched for COPD subjects (COPDGene, NETT, GenKOLS and TESRA) using a combined European-ancestry white (EA) dataset and a COPDGene African American (AA) dataset. We assesse...
Source: Am J Respir Cell Mol... - Category: Respiratory Medicine Authors: Tags: Am J Respir Cell Mol Biol Source Type: research
Purpose of review Chronic obstructive pulmonary disease (COPD) is a well established risk factor for lung cancer. Newer studies reveal a myriad of other mechanisms, some proven and some putative, which may contribute to their association. Recent findings There is an ever-growing bundle of evidence that suggests a close association between persistent chronic inflammation and lung cancer. A few potential targets of genetic susceptibility locus for COPD and lung cancer have been suggested. Better characterization of immune dysregulation and identification of signaling pathways may assist the development of strategies to ...
Source: Current Opinion in Pulmonary Medicine - Category: Respiratory Medicine Tags: OBSTRUCTIVE, OCCUPATIONAL AND ENVIRONMENTAL DISEASES: Edited by Manish Joshi and Basil Varkey Source Type: research
RA Abstract Phenotyping of chronic obstructive pulmonary disease (COPD) with computed tomography (CT) is used to distinguish between emphysema- and airway-dominated type. The phenotype is reflected in correlations with lung function measures. Among these, the relative value of body plethysmography has not been quantified. We addressed this question using CT scans retrospectively collected from clinical routine in a large COPD cohort. Three hundred and thirty five patients with baseline data of the German COPD cohort COPD and Systemic Consequences-Comorbidities Network were included. CT scans were primarily evalua...
Source: Chronic Respiratory Disease - Category: Respiratory Medicine Authors: Tags: Chron Respir Dis Source Type: research
Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease in which the amount of emphysema and airway disease may be very different between individuals, even in end-stage disease. Emphysema formation may be linked to the involvement of the small pulmonary vessels. The NAPDH oxidase (Nox) family is emerging as a key disease-related factor in vascular diseases, but currently its role in hypoxia-induced pulmonary remodelling in COPD remains unclear. Here we investigate the role of p22phox, a regulatory subunit of Nox, in COPD lungs, hypoxic pulmonary vasoconstriction (HPV), hypoxia-induced pulmonary vascular rem...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: COPD and smoking, Pulmonary vascular disease Original Articles: COPD and hypoxia Source Type: research
Conclusions In this proof-of-concept demonstration, we evaluated CT and MRI lung emphysema measurements and observed significantly worse MRI biomarkers of emphysema in patients with AATD compared to patients with COPD, although CT RA950 and diffusing capacity of carbon monoxide were not significantly different, underscoring the sensitivity of MRI measurements of AATD emphysema.
Source: Academic Radiology - Category: Radiology Source Type: research
Alpha-1-antitrypsin deficiency (AATD) is a genetic disorder that is associated with a higher risk of chronic obstructive pulmonary disease (COPD) and emphysema. The annual declines in lung function (FEV1) and transfer factor of the lung for carbon monoxide (TLCO) predict all-cause mortality.
Source: Respiratory Medicine - Category: Respiratory Medicine Authors: Source Type: research
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