RT Journal Article
SR Electronic
T1 Prevalence and clinical correlates of bronchoreversibility in severe emphysema
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1048
OP 1056
DO 10.1183/09031936.00052509
VO 35
IS 5
A1 M. K. Han
A1 R. Wise
A1 J. Mumford
A1 F. Sciurba
A1 G. J. Criner
A1 J. L. Curtis
A1 S. Murray
A1 A. Sternberg
A1 G. Weinman
A1 E. Kazerooni
A1 A. P. Fishman
A1 B. Make
A1 E. A. Hoffman
A1 Z. Mosenifar
A1 F. J. Martinez
A1 for the NETT Research Group
YR 2010
UL http://erj.ersjournals.com/content/35/5/1048.abstract
AB Chronic obstructive pulmonary disease (COPD) exhibits airflow obstruction that is not fully reversible. The importance of bronchoreversibility remains controversial. We hypothesised that an emphysematous phenotype of COPD would be associated with decreased bronchoreversibility. 544 patients randomised to the medical arm of the National Emphysema Treatment Trial formed the study group. Participants underwent multiple measurements of bronchoreversibility on a mean of four sessions over 1.91 yrs. They were also characterised by measures of symptoms, quality of life and quantitative measures of emphysema by computed tomography. Mean baseline forced expiratory volume in 1 s (FEV1) in this patient population is 24% predicted. 22.2% of patients demonstrated bronchoreversibility on one or more occasions using American Thoracic Society/European Respiratory Society criteria. Few patients (0.37%) had bronchoreversibility on all completed tests. Patients who demonstrated bronchoreversibility were more likely to be male, and have better lung function and less emphysema. 64% of patients demonstrated large (≥400 mL) changes in forced vital capacity (FVC). In a severe emphysema population, bronchoreversibility as defined by change in FEV1 is infrequent, varies over time, and is more common in males and those with less severe emphysema. Improvements in FVC, however, were demonstrated in the majority of patients.