• Jae Seung Lee, Seon Ok Kim, Joon Beom Seo, Ji-Hyun Lee, Eun Kyung Kim, Tae-Hyung Kim, Woo Jin Kim, Jin Hwa Lee, Sang-Min Lee, Sangyeub Lee, Seong Yong Lim, Tae Rim Shin, Ho Il Yoon, Sei Won Lee, Jin Won Huh, Yeon-Mok Oh, and Sang-Do Lee.
• Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Olympic-ro 43 gil, Sonpa-gu, Seoul, 138-736, South Korea.
• Lung. 2013 Aug 1;191(4):405-12.

BackgroundThe progression of lung hyperinflation in patients with chronic obstructive pulmonary disease (COPD) has not been studied in a long-term prospective cohort. We explored the longitudinal changes in lung volume compartments with the aim of identifying predictors of a rapid decline of the inspiratory capacity to total lung capacity ratio (IC/TLC).MethodsThe study population comprised 324 patients with COPD who were recruited prospectively. Annual rates of changes in pulmonary function, including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), total lung capacity (TLC), functional residual capacity (FRC), residual volume (RV), vital capacity (VC), IC, and IC/TLC, were estimated using the random coefficient models.ResultsThe mean annual rates of changes in pre- and post-bronchodilator FEV1 were -23.0 mL/year (p < 0.001) and -26.5 mL/year (p = 0.004). The mean annual rates of changes in VC, IC, TLC, and IC/TLC were -33.7 mL/year (p = 0.007), -53.9 mL/year (p < 0.001), -43.7 mL/year (p = 0.012), and -0.65%/year (p = 0.001), respectively. RV, FRC, and RV/TLC did not change significantly during the study period. Multivariate logistic regression analysis showed that a high modified Medical Research Council (MMRC) dyspnea scale score, a high Charlson comorbidity index value, and low post-bronchodilator FEV1 were associated with rapid decline in IC/TLC.ConclusionMMRC dyspnea scale, post-bronchodilator FEV1, and the Charlson comorbidity index at baseline were independent predictors of a rapid decline in IC/TLC.

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