SIGNIFICANCE OF NON-INVASIVE METHODS IN THE EVALUATION OF COPD

Abstract

SESSION TITLE: Obstructive Lung Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Chronic obstructive pulmonary disease (COPD) is a heterogeneous and complex disease that needs personalized treatment. Coexisting bronchiectasis is common in COPD. But the value of non-invasive methods for assessing the clinical phenotypes of COPD has not been adequately studied. METHODS: Patients with stable COPD were retrospectively enrolled. Patient characteristics, fractional exhaled nitric oxide (FeNO) values, pulmonary function test, bronchodilator reversibility test, the results of blood tests for systemic inflammatory markers, and high-resolution computed tomography (HRCT) were obtained. These data were used to assess the factors associated with the clinical phenotype of COPD. RESULTS: Two hundred and seventeen patients were enrolled. The majority of the patients were male (81.57%) and had an average age of 68.14±9.44 years old. The predicted percentages of forced expiratory volume in 1 s (FEV1) and the ratio of FEV1 and forced vital capacity were 45.59%±16.63% and 50.53%±11.70%, respectively. Eighty-four (38.71%) of the patients with COPD had bronchiectasis. COPD patients with bronchiectasis demonstrated a high airflow obstruction level but poorer bronchodilator response following bronchodilation that those without bronchiectasis (P<0.05). FeNO was significantly lower in COPD patients with bronchiectasis than those without bronchiectasis (P=0.005) and negatively correlated with HRCT scores of bronchiectasis severity (P = 0.0021, r = −0.3306). Systemic inflammatory markers C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were higher in COPD patients with bronchiectasis than those without bronchiectasis (P<0.05). CONCLUSIONS: A remarkable proportion of COPD patients have bronchiectasis. COPD with bronchiectasis demonstrates lower level of FeNO, higher level of systemic inflammation and worse pulmonary function with poorer bronchodilation response. FeNO can be used as a biomarker to reflect the bronchiectasis severity in COPD. The evaluation will provide a better understanding of clinical phenotypes in COPD and lead to a more individualized and effective therapy. CLINICAL IMPLICATIONS: Bronchiectasis is common in COPD patients. Non-invasive methods like FeNO and systemic inflammation markers are useful in evaluation of bronchiectasis in COPD. DISCLOSURES: No relevant relationships by Gengpeng Lin, source=Web Response No relevant relationships by Qionghui Liu, source=Web Response No relevant relationships by Jia Shi, source=Web Response