AI Article Synopsis

  • Chronic obstructive pulmonary disease (COPD) traditionally requires a fixed spirometric ratio of FEV/FVC < 0.70 post-bronchodilator, while variable obstruction (VO) is when this ratio improves with treatment but is < 0.70 pre-treatment.
  • A study analyzed data from the SPIROMICS cohort to compare participants with VO to those without obstruction, looking at lung function, health status, and exacerbation rates.
  • Results showed that participants with VO had a significantly higher risk (6.2 times) of developing COPD in the future, prompting a suggestion to revise COPD definitions to include pre-bronchodilator obstruction.

Article Abstract

Chronic obstructive pulmonary disease (COPD) is defined by fixed spirometric ratio, FEV/FVC < 0.70 after inhaled bronchodilators. However, the implications of variable obstruction (VO), in which the prebronchodilator FEV/FVC ratio is less than 0.70 but increases to 0.70 or more after inhaled bronchodilators, have not been determined. We explored differences in physiology, exacerbations, and health status in participants with VO compared with reference participants without obstruction. Data from the SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study) cohort were obtained. Participants with VO were compared with reference participants without obstruction. We assessed differences in baseline radiographic emphysema and small airway disease at study entry, baseline, and change in lung function by spirometry, functional capacity by 6-minute walk, health status using standard questionnaires, exacerbation rates, and progression to COPD between the two groups. All models were adjusted for participant characteristics, asthma history, and tobacco exposure. We assessed 175 participants with VO and 603 reference participants without obstruction. Participants with VO had 6.2 times the hazard of future development of COPD controlling for other factors (95% confidence interval, 4.6-8.3;  < 0.001). Compared with reference participants, the VO group had significantly lower baseline pre- and post-bronchodilator (BD) FEV, and greater decline over time in post-BD FEV, and pre- and post-BD FVC. There were no significant differences in exacerbations between groups. Significant risk for future COPD development exists for those with pre- but not post-BD airflow obstruction. These findings support consideration of expanding spirometric criteria defining COPD to include pre-BD obstruction. Clinical trial registered with www.clinicaltrials.gov (NCT01969344).

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9716898PMC
http://dx.doi.org/10.1164/rccm.202201-0094OCDOI Listing

Publication Analysis

Top Keywords

chronic obstructive
8
obstructive pulmonary
8
pulmonary disease
8
reversible airflow
4
airflow obstruction
4
obstruction predicts
4
predicts future
4
future chronic
4
disease development
4
development spiromics
4

Similar Publications

Background: Recent studies provide strong evidence for a key role of skeletal muscle pathophysiology in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). In a 2021 review article on the pathophysiology of ME/CFS, we postulated that hypoperfusion and ischemia can result in excessive sodium and calcium overload in skeletal muscles of ME/CFS patients to cause mitochondrial damage. Since then, experimental evidence has been provided that supports this concept.

View Article and Find Full Text PDF

Role of diaphragmatic ultrasound in patients with acute exacerbation of chronic obstructive pulmonary disease.

World J Clin Cases

December 2024

Department of Medicine and Pharmacology, Texas A and M University, College Station, TX 77843, United States.

Assessing diaphragm function status is vital for diagnosing and treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Diaphrag-matic ultrasound has become increasingly important due to its non-invasive nature, absence of radiation exposure, widespread availability, prompt results, high accuracy, and repeatability at the bedside. The diaphragm is a crucial respiratory muscle.

View Article and Find Full Text PDF

History of Renal Stone Surgery: A Narrative Review.

Cureus

November 2024

Medicine and Surgery, Foresterhill Health Campus, Aberdeen, GBR.

Untreated obstruction of the urinary tract can result in urinary stasis, hydronephrosis, and infection, which in turn lead to tissue damage, chronic renal failure, and potentially death. Renal stones have afflicted humanity throughout history, with surgical approaches evolving significantly over time. This review explores the origins and major developments in surgical techniques for renal stones, enhancing our understanding of how modern procedures have evolved.

View Article and Find Full Text PDF

Background: Obstructive sleep apnea syndrome (OSAS) is a chronic syndrome, affecting about 1%-5% of children. OSAS is characterized by increased resistance and collapse of the upper airways, with different degrees of severity requiring interventions ranging from lifestyle modifications to surgery. Sympathetic activity is increased in OSAS, and the reduction of disease symptoms, occurring after adenotonsillectomy, correlates with biomarkers indicating a reduced sympathetic response.

View Article and Find Full Text PDF

Retroperitoneal fibrosis (RPF) is a rare disease with a nonspecific presentation. RPF can be classified into Idiopathic, the most common, or secondary due to malignancy and various medications resulting in chronic inflammation and fibrosis in the retroperitoneum. The complications arise due to the compression of structures in the retroperitoneum.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!