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Int. J. Tuberc. Lung Dis. · Jun 2020
Distinctive patterns of pulmonary function change according to baseline lung volume and diffusing capacity.
- J Kang, Y-M Oh, J-H Lee, E K Kim, S Y Lim, W J Kim, H I Yoon, T-H Kim, T S Park, S O Kim, S W Lee, S-D Lee, and J S Lee.
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul.
- Int. J. Tuberc. Lung Dis. 2020 Jun 1; 24 (6): 597-605.
SETTING: Multicentre retrospective study in South Korea.ObjectiveTo longitudinally evaluate changes in lung volume and diffusing capacity for carbon monoxide (DLCO) with forced expiratory volume in 1 sec (FEV1).DESIGN: A total of 155 patients with chronic obstructive pulmonary disease (COPD), whose pulmonary function parameters were measured annually for 5 years, were selected from a prospective cohort in South Korea. A random coefficients model was used to estimate mean annual FEV1, lung volume parameter and DLCO change rates.ResultsPatients were classified into four groups based on baseline DLCO and residual volume/total lung capacity (RV/TLC) measurements. The annual FEV1 decline rate was greater in patients with low DLCO than in those with normal DLCO, with the greatest decline occurring in patients with low DLCO and normal RV/TLC. RV and RV/TLC declined in patients with high RV/TLC, whereas these increased in patients with normal RV/TLC. DLCO decreased longitudinally in all four groups, with the greatest decline occurring in patients with normal DLCO and normal RV/TLC.ConclusionsDifferent subgroups of patients with COPD exhibited distinctive pulmonary function change patterns. Baseline DLCO and RV/TLC may be used as physiological markers to predict long-term changes in pulmonary function.
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