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Improvement in FEV1 after acute COPD exacerbations are driven more by changes in hyperinflation than changes in proximal airway volume

Cedric Van Holsbeke, Wim Vos, Wouter Van Geffen, Huib Kerstjens, Massimo Pistolesi, Omar Usmani, Bita Hajian, Anthony Cahn, Jan De Backer, Wilfried De Backer
European Respiratory Journal 2015 46: PA4612; DOI: 10.1183/13993003.congress-2015.PA4612
Cedric Van Holsbeke
1Respiratory, FLUIDDA, Kontich, Belgium
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Wim Vos
1Respiratory, FLUIDDA, Kontich, Belgium
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Wouter Van Geffen
2Faculty of Medical Sciences, Lung Diseases, University of Gronigingen, Gronigingen, Netherlands
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Huib Kerstjens
2Faculty of Medical Sciences, Lung Diseases, University of Gronigingen, Gronigingen, Netherlands
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Massimo Pistolesi
3Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy
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Omar Usmani
4Faculty of Medicine, National Heart & Lung Institute, Imperial College London, London, United Kingdom
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Bita Hajian
5Departement of Pulmonary Medicine, University of Antwerp, Edegem, Belgium
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Anthony Cahn
6Respiratory Medicine Discovery and Development, GlaxoSmithKline, Stevenage Herts, United Kingdom
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Jan De Backer
1Respiratory, FLUIDDA, Kontich, Belgium
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Wilfried De Backer
5Departement of Pulmonary Medicine, University of Antwerp, Edegem, Belgium
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Abstract

Recovering from a COPD exacerbation is typically associated with an improvement in FEV1. The common perception is that FEV1 is determined by the characteristics of the larger airways (generations 2-6).

Aims: We investigated the relationship between changes in FEV1, airway volume and lung hyperinflation in patients recovering from an acute COPD exacerbation.

Methods: Airway volume and hyperinflation were assessed using a novel imaging method called Functional Respiratory Imaging (FRI) in 50 COPD patients during an acute exacerbation and 6-8 weeks after recovery.

Results: A significant correlation was observed between the improvement in FEV1 and the change in FRI based airway volume (R = 0.3, p = 0.045,). However, the change in FEV1 with FRI based hyperinflation was considerably stronger (R = 0.46, p = 0.002).

Conclusions: Our data suggest changes in FEV1 after an acute COPD exacerbation are more likely driven by changes in hyperinflation, possibly resulting from small airways inflammation, than larger airway inflammation. We are now evaluating a multiple regression model to determine the contribution of changes in individual FRI based parameters to the overall change in FEV1

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  • COPD - exacerbations
  • Imaging
  • Physiology
  • Copyright ©ERS 2015
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Improvement in FEV1 after acute COPD exacerbations are driven more by changes in hyperinflation than changes in proximal airway volume
Cedric Van Holsbeke, Wim Vos, Wouter Van Geffen, Huib Kerstjens, Massimo Pistolesi, Omar Usmani, Bita Hajian, Anthony Cahn, Jan De Backer, Wilfried De Backer
European Respiratory Journal Sep 2015, 46 (suppl 59) PA4612; DOI: 10.1183/13993003.congress-2015.PA4612

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Improvement in FEV1 after acute COPD exacerbations are driven more by changes in hyperinflation than changes in proximal airway volume
Cedric Van Holsbeke, Wim Vos, Wouter Van Geffen, Huib Kerstjens, Massimo Pistolesi, Omar Usmani, Bita Hajian, Anthony Cahn, Jan De Backer, Wilfried De Backer
European Respiratory Journal Sep 2015, 46 (suppl 59) PA4612; DOI: 10.1183/13993003.congress-2015.PA4612
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