論文

査読有り 国際誌
2020年7月

Lobar distribution of non-emphysematous gas trapping and lung hyperinflation in chronic obstructive pulmonary disease.

Respiratory investigation
  • Hiroshi Shima
  • Naoya Tanabe
  • Susumu Sato
  • Tsuyoshi Oguma
  • Takeshi Kubo
  • Satoshi Kozawa
  • Koji Koizumi
  • Aya Watanabe
  • Atsuyasu Sato
  • Kaori Togashi
  • Toyohiro Hirai
  • 全て表示

58
4
開始ページ
246
終了ページ
254
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.resinv.2020.01.001

BACKGROUND: Lung hyperinflation in chronic obstructive pulmonary disease (COPD) is closely associated with emphysema and non-emphysematous gas trapping, termed functional small airway disease (fSAD), on inspiratory and expiratory computed tomography (CT). Because the cranial-caudal emphysema distribution affects pulmonary function and fSAD may precede emphysema on CT, we tested the hypothesis that lobar fSAD distribution would affect lung hyperinflation differently in COPD with minimal and established emphysema. METHODS: The volume percentages of fSAD and emphysema (fSAD% and Emph%) over the upper and lower lobes were measured using inspiratory and expiratory CT in 70 subjects with COPD. Subjects were divided into those with minimal and established emphysema (n = 36 and 34) using a threshold of 10% Emph% in the whole lung. RESULTS: In the minimal emphysema group, fSAD% in the upper and lower lobes was positively correlated with functional residual capacity (FRC) and residual volume to total lung capacity ratio (RV/TLC), and the correlation of fSAD% with RV/TLC was greater in the lower lobes. Conversely, in the established emphysema group, fSAD% in the upper and lower lobes was correlated with RV/TLC, but not with FRC. In multivariate analysis, fSAD% in the lower lobes, but not in the upper lobes, was associated with RV/TLC in subjects with minimal emphysema after adjusting for age, smoking status, and bronchodilator use. CONCLUSION: Non-emphysematous gas trapping in the upper and lower lobes has a distinct physiological effect, especially in COPD with minimal emphysema. This local evaluation might allow sensitive detection of changes in lung hyperinflation in COPD.

リンク情報
DOI
https://doi.org/10.1016/j.resinv.2020.01.001
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32085990
ID情報
  • DOI : 10.1016/j.resinv.2020.01.001
  • PubMed ID : 32085990

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