Small airway pathology and bronchoreversibility in advanced emphysema.
Publication/Presentation Date
4-1-2010
Abstract
BACKGROUND: Poorly reversible airflow obstruction is a hallmark feature of chronic obstructive pulmonary disease (COPD). However, some COPD patients demonstrate significant bronchodilator reversibility (BDR). The pathologic features associated with the presence or absence of this phenomenon are not known.
METHODS: We analyzed 67 patients with advanced upper lobe predominant emphysema who underwent lung volume reduction surgery and divided them into 2 groups: the reversible group [BD(+)] had a >12% and >200 mL increase in FEV(1) or FVC with bronchodilator; the irreversible group [BD(-)] had a
RESULTS: Despite similar baseline characteristics, the BD(+) group had a smaller EH (0.036 mm vs. 0.042 mm, p = 0.005) and EH/BMP (0.012 vs. 0.014, p = 0.007), and a greater SMWA/BMA (0.491 vs. 0.430, p = 0.034) compared to the BD(-) group. In addition, EA trended to be smaller in the BD(+) group when compared to the BD(-) group (0.160 mm(2) vs. 0.184 mm(2), p = 0.06). In a subset of patients with consistent patterns of BDR on serial testing, the BD(+) group had greater SMWA/BMA (0.518 vs. 0.433, p = 0.049) and TWA/BMA (1.405 vs. 1.266, p = 0.036) compared to the BD(-) group.
CONCLUSIONS: Small airway smooth muscle mass may play a role in determining BDR in severe emphysema.
Volume
7
Issue
2
First Page
93
Last Page
101
ISSN
1541-2563
Published In/Presented At
Kim, V., Pechulis, R. M., Abuel-Haija, M., Solomides, C. C., Gaughan, J. P., & Criner, G. J. (2010). Small airway pathology and bronchoreversibility in advanced emphysema. COPD, 7(2), 93–101. https://doi.org/10.3109/15412551003631691
Disciplines
Medicine and Health Sciences
PubMedID
20397809
Department(s)
Department of Medicine
Document Type
Article