Comparison of subjects with pulmonary emphysema on computed tomography with and without airflow obstruction on spirometry
Keywords:
COPD, emphysema, spirometric, computed tomography.Abstract
Introduction: Pulmonary emphysema without airflow obstruction is one of the symptoms on which chronic obstructive pulmonary disease can manifest.Objective: To compare patients with pulmonary emphysema in computed tomography with and without airflow obstruction by spirometry.
Methods: Cross-sectional study in subjects over 40 years of age who underwent spirometry and chest tomography in a specialized medical center between 2018 and 2020. A descriptive analysis was performed, summarizing the qualitative variables in frequencies and percentages and the quantitative variables in mean and standard deviation if their distribution was normal, and median and interquartile range if their distribution was not normal. Four groups were constructed based on the presence or absence of tomographic findings of emphysema and pulmonary function tests.
Results: Subjects without emphysema with obstructive alteration presented a greater exposure to wood smoke with 62.5 % and less exposure to smoking with 29.2 %. Forced vital capacity was lower in subjects with emphysema without obstructive alteration when compared with subjects without emphysema and normal lung function tests, forced expiratory volume in 1 second/forced vital capacity ratio was similar in these last two groups.
Conclusion: Subjects with emphysema without obstructive spirometric alteration have a frequent history of smoking, high frequency of dyspnea and lower frequency of cough when compared with patients with obstructive alteration in pulmonary function, the forced vital capacity of subjects with emphysema without obstruction is lower. to that of subjects without emphysema or obstruction.
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References
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2. Han MK, Agusti A, Celli BR, Criner GJ, Halpin DMG, Roche N, et al. From GOLD 0 to Pre-COPD. Am J Respir Crit Care Med. 2021; 203(4):414-23. DOI: 10.1164/rccm.202008-3328PP
3. Nambu A, Zach J, Schroeder J, Jin G, Kim SS, Kim YI, et al. Quantitative computed tomography measurements to evaluate airway disease in chronic obstructive pulmonary disease: Relationship to physiological measurements, clinical index and visual assessment of airway disease. Eur J Radiol. 2016; 85(11):2144-51. DOI: 10.1016/j.ejrad.2016.09.010
4. Mohamed Hoesein FA, de Jong PA, Lammers JW, Mali WP, Schmidt M, de Koning HJ, et al. Airway wall thickness associated with forced expiratory volume in 1 second decline and development of airflow limitation. Eur Respir J. 2015; 45:644-51. DOI: 10.1183/09031936.00020714
5. Mohamed Hoesein FA, de Hoop B, Zanen P, Gietema H, Kruitwagen CL, van Ginneken B, et al. CT-quantified emphysema in male heavy smokers: association with lung function decline. Thorax. 2011; 66:782-7. DOI: 10.1136/thx.2010.145995
6. Mohamed Hoesein FA, van Rikxoort E, van Ginneken B, de Jong PA, Prokop M, Lammers JW, et al. Computed tomography-quantified emphysema distribution is associated with lung function decline. Eur Respir J. 2012; 40:844-50. DOI: 10.1183/09031936.00186311
7. Hernández-Zenteno RJ, Flores-Trujillo F, Vázquez-Cortés JJ, Monteros-Sánchez CEL, Cosío MG. Symptomatic and asymptomatic smokers without airflow obstruction: a new clinical entity? Rev Invest Clin. 2019; 71(1):64-9. DOI: 10.24875/RIC.18002648
8. Wedzicha JA, Ers Co-Chair, Miravitlles M, Hurst JR, Calverley PM, Albert RK, et al. Management of COPD exacerbations: a European Respiratory Society/American Thoracic Society guideline. Eur Respir J. 2017; 49(3):1600791. DOI: 10.1183/13993003.00791-2016
9. Ferrera MC, Labaki WW, Han MK. Advances in Chronic Obstructive Pulmonary Disease. Annu Rev Med. 2021; 72:119-34. DOI: 10.1146/annurev-med-080919-112707
10. Gomes P, Bastos HNE, Carvalho A, Lobo A, Guimarães A, Rodrigues RS, et al. Pulmonary Emphysema Regional Distribution and Extent Assessed by Chest Computed Tomography Is Associated With Pulmonary Function Impairment in Patients With COPD. Front Med (Lausanne). 2021; 8:705184. DOI: 10.3389/fmed.2021.705184
11. Çolak Y, Afzal S, Nordestgaard BG, Vestbo J, Lange P. Prognosis of asymptomatic and symptomatic, undiagnosed COPD in the general population in Denmark: a prospective cohort study. Lancet Respir Med. 2017; 5(5):426-34. DOI: 10.1016/S2213-2600(17)30119-4
12. Menezes AM, Muiño A, López-Varela MV, Valdivia G, Lisboa C, Jardim JR, et al. A population-based cohort study on chronic obstructive pulmonary disease in Latin America: methods and preliminary results. The PLATINO Study Phase II. Arch Bronconeumol. 2014; 50(1):10-7. DOI: 10.1016/j.arbres.2013.07.014
13. GBD Chronic Respiratory Disease Collaborators. Prevalence and attributable health burden of chronic respiratory diseases, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Respir Med. 2020; 8(6):585-96. DOI: 10.1016/S2213-2600(20)30105-3
14. Regan EA, Lynch DA, Curran-Everett D, Curtis JL, Austin JH, Grenier PA, et al. Clinical and Radiologic Disease in Smokers With Normal Spirometry. JAMA Intern Med. 2015; 175(9):1539-49. DOI: 10.1001/jamainternmed.2015.2735
15. Wouters EFM, Breyer MK, Breyer-Kohansal R, Hartl S. COPD Diagnosis: Time for Disruption. J Clin Med. 2021; 10(20):4660. DOI: 10.3390/jcm10204660
16. Woodruff PG, Barr RG, Bleecker E, Christenson SA, Couper D, Curtis JL, et al. Clinical Significance of Symptoms in Smokers with Preserved Pulmonary Function. N Engl J Med. 2016; 374(19):1811-21. DOI: 10.1056/NEJMoa1505971
17. Schroeder JD, McKenzie AS, Zach JA, Wilson CG, Curran-Everett D, Stinson DS, et al. Relationships between airflow obstruction and quantitative CT measurements of emphysema, air trapping, and airways in subjects with and without chronic obstructive pulmonary disease. AJR Am J Roentgenol. 2013; 201(3):W460-70. DOI: 10.2214/AJR.12.10102
18. Miravitlles M, Ribera A. Understanding the impact of symptoms on the burden of COPD. Respir Res. 2017; 18(1):67. DOI: 10.1186/s12931-017-0548-3
19. Kessler R, Partridge MR, Miravitlles M, Cazzola M, Vogelmeier C, Leynaud D, et al. Symptom variability in patients with severe COPD: a pan-European cross-sectional study. Eur Respir J. 2011; 37(2):264-72. DOI: 10.1183/09031936.00051110
20. Schroeder JD, McKenzie AS, Zach JA, Wilson CG, Curran-Everett D, Stinson DS, et al. Relationships between airflow obstruction and quantitative CT measurements of emphysema, air trapping, and airways in subjects with and without chronic obstructive pulmonary disease. AJR Am J Roentgenol. 2013; 201(3):W460-70. DOI: 10.2214/AJR.12.10102
21. Bhatt SP, Bhakta NR, Wilson CG, Cooper CB, Barjaktarevic I, Bodduluri S, et al. New Spirometry Indices for Detecting Mild Airflow Obstruction. Sci Rep. 2018; 8(1):17484. DOI: 10.1038/s41598-018-35930-2
Published
2022-07-22
How to Cite
1.
Tuta Quintero E, Bastidas Goyes A, Díaz Quijano D, Diago M, Buitrago M, Charry Borrero D, et al. Comparison of subjects with pulmonary emphysema on computed tomography with and without airflow obstruction on spirometry. Rev Cubana Med Milit [Internet]. 2022 Jul. 22 [cited 2025 Jan. 10];51(3):e02202032. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/2032
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