• Xian Wen Sun, Shu Yi Gu, Qing Yun Li, Lei Ren, Ji Min Shen, Huan Ying Wan, Shao Guang Huang, and Wei Wu Deng.
• Department of Respiratory Medicine (XWS, SYG, QYL, LR, JMS, HYW, SGH, WWD), Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Respiratory Medicine (SYG), Shanghai Pneumology Hospital, School of Medicine, Tong Ji University, Shanghai, China; and Department of Respiratory Medicine (LR), Shanghai Jin-an Geriatric Hospital, Shanghai, China.
• Am. J. Med. Sci. 2015 Mar 1; 349 (3): 228-33.

BackgroundHeterogeneity of clinical presentation of chronic obstructive pulmonary disease (COPD) attributes to different pathological basis. High-resolution computed tomography (HRCT) phenotypes of COPD may reflex the pathological basis of COPD indirectly by evaluating the small airway inflammation and emphysema. How the pulmonary function related with different HRCT phenotypes has not been well known. The aim was to explore the features of pulmonary function parameters in the 3 phenotypes.MethodsSixty-three stable COPD patients were allocated in 3 groups based on HRCT findings: phenotype A (absence of emphysema, with minimal evidence of emphysema with or without bronchial wall thickening [BWT]), phenotype E (emphysema without BWT) and phenotype M (emphysema with BWT). The pulmonary function testing was also analyzed.ResultsThe values of forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC%), FEV1% and maximum expiratory flows (MEF)50% were the highest in phenotype A (P < 0.05), so was residual volume (RV)/total lung capacity (TLC%) in phenotype E (P < 0.05). Those with MEF50/MEF25 ratio >4.0 were more prevalence in phenotype A than in E and M (odds ratio = 2.214; P < 0.05). The occurrences of RV/TLC% >40% were higher in phenotype E than in A and M (odds ratio = 3.906; P < 0.05). Receiver operating characteristic analysis showed that the cutoff value of MEF50/MEF25 ratio for identifying phenotype A was 2.5, with sensitivity 66.7% and specificity 92.9%. The cutoff value of RV/TLC% for identifying phenotype E was 57.4%, with sensitivity 75.0% and specificity 79.1%.ConclusionsThe different features of pulmonary function parameters were found in various HRCT phenotypes; MEF50/MEF25 ratio could imply phenotype A, whereas RV/TLC% may be the indicator of phenotype E.

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