Prevalence and clinical correlates of bronchoreversibility in severe emphysema

M. K. Han, R. Wise, J. Mumford, F. Sciurba, G. J. Criner, J. L. Curtis, S. Murray, A. Sternberg, G. Weinman, E. Kazerooni, A. P. Fishman, B. Make, E. A. Hoffman, Z. Mosenifar, F. J. Martinez

Research output: Contribution to journalArticlepeer-review

Abstract

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. Copyright

Original languageEnglish (US)
Pages (from-to)1048-1056
Number of pages9
JournalEuropean Respiratory Journal
Volume35
Issue number5
DOIs
StatePublished - May 2010

Keywords

  • Bronchodilator
  • Chronic obstructive pulmonary disease
  • Computed tomography
  • Emphysema

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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