RT Journal Article
SR Electronic
T1 Internal airflow distribution is driven by lobar volume, hyperinflation and emphysema score in COPD patients
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2137
VO 44
IS Suppl 58
A1 Wilfried De Backer
A1 Cedric Van Holsbeke
A1 Rita Claes
A1 Annemie Hufkens
A1 Lieven Bedert
A1 Peter van Hal
A1 Jan De Backer
A1 Wim Vos
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2137.abstract
AB RationaleCOPD is characterized by tissue and airway wall inflammation, distortion and destruction (emphysema, small airway disease). This trial tries to identify the influence of hallmark characteristics of COPD on regional ventilation in patients.MethodsFor 28 patients (21M, 66.3±6.4y, 8/18/2 GOLD II/II/IV, FEV1=43.9±11.9%p) FRI-based regional measures on lobar volume, hyperinflation, perfusion, emphysema and ventilation were obtained from breathing gated HRCT scans at FRC and TLC. A generalized estimating equation was fit to the data in order to predict regional ventilation in function of the other parameters, correcting for lobar repeated measures within a patient.ResultsA positive correlation was found between regional ventilation and static lung volume (p<0.001). Emphysema (p=0.017) and hyperinflation (p=0.028), independently, have a negative correlation with ventilation, while perfusion does not have a direct influence on ventilation (p=0.98).ConclusionsIt could be seen that airflow distribution is mainly driven by the static lobe volume, i.e. larger lobes attract more air than smaller lobes. However, this correlation is counteracted by the presence of emphysema and/or other reasons for hyperinflation. This means that also hyperinflated regions with predominant small airways disease receive less ventilation and hence a less optimal distribution of inhaled treatments.This study was funded by Takeda.