Diffusing Capacity of Carbon Monoxide in Assessment of COPD.
COPD
pulmonary diffusing capacity
pulmonary gas exchange
Journal
Chest
ISSN: 1931-3543
Titre abrégé: Chest
Pays: United States
ID NLM: 0231335
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
13
03
2019
revised:
10
06
2019
accepted:
14
06
2019
pubmed:
29
7
2019
medline:
29
5
2020
entrez:
29
7
2019
Statut:
ppublish
Résumé
Diffusing capacity of the lung for carbon monoxide (Dlco) is inconsistently obtained in patients with COPD, and the added benefit of Dlco testing beyond that of more common tools is unknown. The goal of this study was to determine whether lower Dlco is associated with increased COPD morbidity independent of emphysema assessed via spirometry and CT imaging. Data for 1,806 participants with COPD from the Genetic Epidemiology of COPD (COPDGene) study 5-year visit were analyzed, including pulmonary function testing, quality of life, symptoms, exercise performance, and exacerbation rates. Dlco percent predicted was primarily analyzed as a continuous variable and additionally categorized into four groups: (1) Dlco and FEV In multivariable analyses, every 10% predicted decrease in Dlco was associated with symptoms and quality of life (COPD Assessment Test, 0.53 [P < .001]; St. George's Respiratory Questionnaire, 1.67 [P < .001]; Medical Outcomes Study Short Form 36 Physical Function, -0.89 [P < .001]), exercise performance (6-min walk distance, -45.35 feet; P < .001), and severe exacerbation rate (rate ratio, 1.14; P < .001). When categorized, severe impairment in Dlco alone, FEV Impairment in Dlco was associated with increased COPD symptoms, reduced exercise performance, and severe exacerbation risk even after accounting for spirometry and CT evidence of emphysema. These findings suggest that Dlco should be considered for inclusion in future multidimensional tools assessing COPD.
Sections du résumé
BACKGROUND
Diffusing capacity of the lung for carbon monoxide (Dlco) is inconsistently obtained in patients with COPD, and the added benefit of Dlco testing beyond that of more common tools is unknown.
OBJECTIVE
The goal of this study was to determine whether lower Dlco is associated with increased COPD morbidity independent of emphysema assessed via spirometry and CT imaging.
METHODS
Data for 1,806 participants with COPD from the Genetic Epidemiology of COPD (COPDGene) study 5-year visit were analyzed, including pulmonary function testing, quality of life, symptoms, exercise performance, and exacerbation rates. Dlco percent predicted was primarily analyzed as a continuous variable and additionally categorized into four groups: (1) Dlco and FEV
RESULTS
In multivariable analyses, every 10% predicted decrease in Dlco was associated with symptoms and quality of life (COPD Assessment Test, 0.53 [P < .001]; St. George's Respiratory Questionnaire, 1.67 [P < .001]; Medical Outcomes Study Short Form 36 Physical Function, -0.89 [P < .001]), exercise performance (6-min walk distance, -45.35 feet; P < .001), and severe exacerbation rate (rate ratio, 1.14; P < .001). When categorized, severe impairment in Dlco alone, FEV
CONCLUSIONS
Impairment in Dlco was associated with increased COPD symptoms, reduced exercise performance, and severe exacerbation risk even after accounting for spirometry and CT evidence of emphysema. These findings suggest that Dlco should be considered for inclusion in future multidimensional tools assessing COPD.
Identifiants
pubmed: 31352035
pii: S0012-3692(19)31377-7
doi: 10.1016/j.chest.2019.06.035
pmc: PMC7242635
pii:
doi:
Substances chimiques
Carbon Monoxide
7U1EE4V452
Banques de données
ClinicalTrials.gov
['NCT00608764']
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1111-1119Subventions
Organisme : NHLBI NIH HHS
ID : T32 HL007534
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL089856
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL089897
Pays : United States
Organisme : NHLBI NIH HHS
ID : T32 HL007534-36
Pays : United States
Informations de copyright
Copyright © 2019. Published by Elsevier Inc.
Références
Am Rev Respir Dis. 1959 Jul;80(1, Part 2):67-93
pubmed: 13670406
Am Rev Respir Dis. 1979 Jun;119(6):895-902
pubmed: 453709
Thorax. 2012 Nov;67(11):957-63
pubmed: 22684094
Eur Respir J. 2005 Aug;26(2):319-38
pubmed: 16055882
Am Rev Respir Dis. 1990 Jan;141(1):53-61
pubmed: 2297187
Int J Chron Obstruct Pulmon Dis. 2016 Jun 28;11:1435-45
pubmed: 27418816
Eur Respir J. 2017 Sep 11;50(3):
pubmed: 28893868
NCHS Data Brief. 2017 Dec;(293):1-8
pubmed: 29319473
J Thorac Dis. 2016 Jun;8(6):1274-82
pubmed: 27293847
Pneumologie. 2014 Apr;68(4):266-9
pubmed: 24615667
Am Rev Respir Dis. 1973 Dec;108(6):1373-83
pubmed: 4751722
N Engl J Med. 2010 Sep 16;363(12):1128-38
pubmed: 20843247
Proc R Soc Med. 1965 Sep;58(9):684-7
pubmed: 5826197
Am J Epidemiol. 1998 Jun 1;147(11):1011-8
pubmed: 9620044
COPD. 2017 Jun;14(3):267-275
pubmed: 28368706
Thorax. 2013 Aug;68(8):752-9
pubmed: 23604381
COPD. 2013 Apr;10(2):180-5
pubmed: 23547629
Radiology. 2011 Oct;261(1):274-82
pubmed: 21788524
Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7
pubmed: 12091180
Am J Med. 1983 Feb;74(2):249-55
pubmed: 6600584
Eur Respir J. 2002 Apr;19(4):632-8
pubmed: 11998991
Am J Respir Crit Care Med. 2013 Jul 15;188(2):231-9
pubmed: 23656466
Thorax. 1988 Mar;43(3):183-9
pubmed: 3406902
Eur Respir J. 2013 Sep;42(3):616-25
pubmed: 23349449
Chest. 2007 Oct;132(4):1191-7
pubmed: 17890472
Eur Respir Rev. 2017 Jan 17;26(143):
pubmed: 28096287
Eur Respir J. 1991 Feb;4(2):141-6
pubmed: 2044729
Chest. 2018 May;153(5):1106-1115
pubmed: 29054347
PLoS One. 2016 Apr 05;11(4):e0152987
pubmed: 27046203
Am J Respir Crit Care Med. 2015 Sep 1;192(5):570-80
pubmed: 26067761
MMWR Morb Mortal Wkly Rep. 2015 Mar 27;64(11):289-95
pubmed: 25811677
Angiology. 1968 Jul-Aug;19(7):399-407
pubmed: 5664335
Am Rev Respir Dis. 1989 May;139(5):1179-87
pubmed: 2712446
Am J Respir Crit Care Med. 2017 Mar 1;195(5):557-582
pubmed: 28128970
COPD. 2010 Feb;7(1):32-43
pubmed: 20214461
Eur Respir J. 2012 Dec;40(6):1324-43
pubmed: 22743675
COPD. 2009 Feb;6(1):59-63
pubmed: 19229709
Int J Chron Obstruct Pulmon Dis. 2016 Jul 27;11:1689-703
pubmed: 27555759
BMC Pulm Med. 2017 Aug 25;17(1):117
pubmed: 28841877
Int J Chron Obstruct Pulmon Dis. 2017 Dec 27;13:121-129
pubmed: 29343951
Eur J Radiol. 2015 May;84(5):980-5
pubmed: 25704753
Circ Cardiovasc Imaging. 2015 Apr;8(4):
pubmed: 25855668
Am J Respir Crit Care Med. 1996 Jul;154(1):187-92
pubmed: 8680679
Respir Res. 2010 Sep 10;11:122
pubmed: 20831787
Lancet Respir Med. 2013 Mar;1(1):43-50
pubmed: 24321803