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  • Title: Longitudinal lung volume changes in patients with chronic obstructive pulmonary disease.
    Author: Lee JS, Kim SO, Seo JB, Lee JH, Kim EK, Kim TH, Kim WJ, Lee JH, Lee SM, Lee S, Lim SY, Shin TR, Yoon HI, Lee SW, Huh JW, Oh YM, Lee SD.
    Journal: Lung; 2013 Aug; 191(4):405-12. PubMed ID: 23715996.
    Abstract:
    BACKGROUND: The 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). METHODS: The 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. RESULTS: The 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. CONCLUSION: MMRC 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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