Symptomatic smokers without COPD have physiological changes heralding the development of COPD
Bazzan, Erica ; Semenzato, Umberto ; Turato, Graziella ; Biondini, Davide ; Cubero, Pablo ; Marin-Oto, Marta (Universidad de Zaragoza) ; Forner, Marta ; Tinè, Mariaenrica ; Casara, Alvise ; Baraldo, Simonetta ; Spagnolo, Paolo ; Marin, Jose M. ; Saetta, Marina ; Cosio, Manuel G.
Resumen: COPD is a major health problem, mainly due to cigarette smoking. Most studies in COPD are dedicated to fully developed COPD in older subjects, even though development of COPD may start soon after smoking initiation. Therefore, there is a need to diagnose this “early disease” by detecting the initial events responsible for ultimate development of COPD.MethodsMeasurement of maximum mid expiratory flow between 25 and 75% of vital capacity (MMEF) in a routine spirometry, which detects small airways disease, was used to investigate if MMEF abnormalities in smokers without COPD (noCOPD) would relate to respiratory symptoms and identify smokers that might progress to COPD. For this purpose we studied 511 smokers, 302 COPD and 209 noCOPD, followed long term with spirometry including MMEF, diffusing capacity of the lung for carbon monoxide (DLCO), 6-min walk test (6MWT), Medical Research Council Dyspnoea Scale and COPD Assessment Test. Three spirometries V1,V2 and V3 (5±2.5 and 10±4 years apart from V1) were performed to assess functional decline and development of COPD.Results65% of noCOPD had an abnormal MMEF (<80%) and 38% an abnormalDLCO. The NoCOPD with MMEF <80% group performed worse in the 6MWT (p=0.01), was more dyspnoeic (p=0.01) and had higher prevalence of chronic bronchitis than the noCOPD with MMEF>80% group (p=0.04). 21% of noCOPD with MMEF <80% and 2.7% with MMEF>80% developed COPD by V3 (p=0.0004).ConclusionsThe MMEF, a functional test available in a routine spirometry, can detect early lung abnormalities and identify the subset of symptomatic smokers with pathological changes that might lead to COPD.
Idioma: Inglés
DOI: 10.1183/23120541.00202-2022
Año: 2022
Publicado en: ERJ Open Research 8, 2 (2022), [11 pp.]
ISSN: 2312-0541
Factor impacto JCR: 4.6 (2022)
Categ. JCR: RESPIRATORY SYSTEM rank: 22 / 66 = 0.333 (2022) - Q2 - T2
Factor impacto CITESCORE: 5.2 - Medicine (Q2)
Factor impacto SCIMAGO: 1.304 - Pulmonary and Respiratory Medicine (Q1)
Tipo y forma: Article (Published version)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes.
Exportado de SIDERAL (2025-01-09-14:41:53)
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Idioma: Inglés
DOI: 10.1183/23120541.00202-2022
Año: 2022
Publicado en: ERJ Open Research 8, 2 (2022), [11 pp.]
ISSN: 2312-0541
Factor impacto JCR: 4.6 (2022)
Categ. JCR: RESPIRATORY SYSTEM rank: 22 / 66 = 0.333 (2022) - Q2 - T2
Factor impacto CITESCORE: 5.2 - Medicine (Q2)
Factor impacto SCIMAGO: 1.304 - Pulmonary and Respiratory Medicine (Q1)
Tipo y forma: Article (Published version)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. Exportado de SIDERAL (2025-01-09-14:41:53)
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Record created 2025-01-09, last modified 2025-01-09