Abstract
Background: In chronic obstructive pulmonary disease (COPD), morphological analysis made by computed tomography (CT) is usually correlated with spirometry as the main functional tool. In this study, quantitative CT analysis (QCT) was compared with volumetric capnography (VCap), alongside spirometry and the 6-min walk test (6MWT). Methods: Twenty-seven patients with severe/very severe COPD were included, compared with nineteen control subjects. All participants performed spirometry and chest high resolution CT scans that were analyzed with fully-automated software. The COPD group was also submitted to VCap and 6MWT. Results: COPD patients (65.07 ± 8.25 years) showed an average FEV1 of 1.2 L (44% of the predicted) and the control group (34.36 ± 8.78 years). VCap × QCT: positive correlations were observed with bronchial wall thickening and negative correlations with diameter and area of the bronchial lumen. Spirometry × QCT: positive correlations were observed between post-BD FVC, FEV1 and FEF 25–75% and diameter and luminal area of the airways and FVC and lung and vascular volumes (emphysema). Negative correlation was observed between post-BD FVC and FEV1 when compared with Pi10 (internal perimeter of 10 mm). 6MWT vs. QCT: negative correlations were observed between the distance covered with relative wall thickness (airways) and vascular volume and peripheral vascular volume (vasculature). Conclusion: Relevant correlations between QCT and pulmonary function variables were found, including the VCap, highlighting the importance of structural analysis in conjunction with a multidimensional functional assessment. This is the first study to correlate airway and parenchyma QCT with VCap.
Highlights
Chronic obstructive pulmonary disease (COPD) is a progressive and heterogeneous lung disease in terms of clinical presentation, risk factors and functional evolution [1,2].Heterogeneity in all aspects of the disease reinforces the importance of differentiated therapy for each patient in order to produce better individual results for disease control [3,4].According to Fletcher et al [5] there is evidence of a close relationship between chronic bronchitis symptoms and cigarette smoking
The computed tomography (CT) data of airways and emphysema are significantly different between the chronic obstructive pulmonary disease (COPD) patients and the controls
The correlations of the spirometry variables found with IE and VE support the findings commonly found in patients with an emphysema phenotype, where a reduction in vital capacity is always significant probably due to air trapping
Summary
Chronic obstructive pulmonary disease (COPD) is a progressive and heterogeneous lung disease in terms of clinical presentation, risk factors and functional evolution [1,2].Heterogeneity in all aspects of the disease reinforces the importance of differentiated therapy for each patient in order to produce better individual results for disease control [3,4].According to Fletcher et al [5] there is evidence of a close relationship between chronic bronchitis symptoms and cigarette smoking. Chronic obstructive pulmonary disease (COPD) is a progressive and heterogeneous lung disease in terms of clinical presentation, risk factors and functional evolution [1,2]. Spirometry × QCT: positive correlations were observed between post-BD FVC, FEV1 and FEF 25–75% and diameter and luminal area of the airways and FVC and lung and vascular volumes (emphysema). Conclusion: Relevant correlations between QCT and pulmonary function variables were found, including the VCap, highlighting the importance of structural analysis in conjunction with a multidimensional functional assessment. This is the first study to correlate airway and parenchyma QCT with VCap
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