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Predominant emphysema phenotype in chronic obstructive pulmonary disease patients

¹ Dept of Experimental and Clinical Medicine, University of Ferrara, Ferrara, ² Institute of Clinical Physiology, CNR, Pisa, ³ Dept of Medicine, Oncology and Radiology, Section of Respiratory Diseases, University of Modena & Reggio Emilia, Modena, and ⁴ Dept of Environmental Medicine and Public Health, University of Padova, Padova, Italy

CORRESPONDENCE: C.E. Mapp, Dipartimento di Medicina Clinica e Sperimentale, Sezione di Igiene e Medicina del Lavoro, Via Fossato di Mortara 64/b, 44100, Ferrara, Italy. Fax: 39 0532205066. E-mail: map@dns.unife.it

Keywords: chronic obstructive pulmonary disease, computed tomography, emphysema

Received: June 6, 2002
Accepted November 20, 2002

This study was supported by the Italian Ministry of University and Research Consorzio Ferrararicherche.

Patients with fixed airflow limitation are grouped under the heading of chronic obstructive pulmonary disease (COPD). The authors investigated whether COPD patients have distinct functional, radiological and sputum cells characteristics depending on the presence or absence of emphysema.

Twenty-four COPD outpatients, 12 with and 12 without emphysema on high-resolution computed tomography scan of the chest, were examined. Patients underwent chest radiography, pulmonary function tests and sputum induction and analysis.

Subjects with documented emphysema had lower forced expiratory volume in one second (FEV₁), FEV₁/forced vital capacity ratio, and lower carbon monoxide diffusion constant (K_CO), compared with subjects without emphysema. Chest radiograph score of emphysema was higher, chest radiograph score of chronic bronchitis was lower, and the number of sputum lymphocytes was increased in patients with emphysema, who also showed a negative correlation between K_CO and pack-yrs.

Chronic obstructive pulmonary disease patients with emphysema, documented by high-resolution computed tomography scan, have a different disease phenotype compared with patients without emphysema. Identification of chronic obstructive pulmonary disease-related phenotypes may improve understanding of the natural history and treatment of the disease.

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