Abstract
Chronic obstructive pulmonary disease (COPD) is a chronic airway disease characterized by persistent airflow limitation. Moreover, lung hyperinflation evaluated by lung volumes is also the key pathophysiologic process during COPD progression. Nevertheless, there is still no preferred method to evaluate lung volumes. For this study, we recruited 170 patients with stable COPD to assess lung volumes stratified by airflow limitation severity. Lung volumes including residual volume (RV) and total lung capacity (TLC) were determined by both body plethysmography and helium dilution methods. The discrepancies between these two methods were recorded as ΔRV%pred, ΔTLC%pred, and ΔRV/TLC. We found that ΔRV%pred, ΔTLC%pred, and ΔRV/TLC increased significantly with the severity of COPD. The differences of lung capacity between these two methods were negatively correlated with FEV1%pred, and diffusing capacity for carbon monoxide (DLCO%pred). Moreover, the receiver operating characteristic (ROC) for ΔTLC%pred to distinguish severe COPD from non-severe COPD had an area under curve (AUC) of 0.886. The differences of lung volume parameters measured by body plethysmography and helium dilution methods were associated with airflow limitation and can effectively differentiate COPD severity, which may be a supportive method to assess the lung function of stable COPD patients.
Highlights
Chronic obstructive pulmonary disease (COPD) is a disease characterized by persistent and progressive airflow limitation
To further confirm the influences of airflow obstruction on lung volume measurement, we studied the correlation of ΔRV%pred, ΔTLC%pred, and ΔRV/ total lung capacity (TLC) with FEV1%pred
We found that the difference of TLC%pred measured by these two methods was strong correlated with FEV1%pred (r =−0.685, p < 0.001, Fig. 2A)
Summary
Chronic obstructive pulmonary disease (COPD) is a disease characterized by persistent and progressive airflow limitation. A gold standard method to evaluate lung volumes has not yet been confirmed Both gas (helium) dilution and whole-body plethysmography (WBP) are common methods to measure lung volume. As the biases of these two methods are both associated with a degree of airflow limitation, the differences between these two methods may provide an alternative marker to reflect the degree of airway obstruction and be an optimal substitute to evaluate the severity of COPD. Based on current evidence of lung volumetric parameters in COPD and potential estimation biases in WBP and MBHD methods, we conducted a prospective correlation and diagnosis analysis to further assess the value of lung volume as well as the differences between these two methods in distinguishing COPD severities, to clarify the influences of airflow limitation on lung volume measurement, and to evaluate the correlation with diffusing capacity
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