Natural Course of the Diffusing Capacity of the Lungs for Carbon Monoxide in COPD
Casanova, Ciro ; Gonzalez-Dávila, Enrique ; Martínez-Gonzalez, Cristina ; Cosio, Borja G. ; Fuster, Antonia ; Feu, Nuria ; Solanes, Ingrid ; Cabrera, Carlos ; Marin, José M. (Universidad de Zaragoza) ; Balcells, Eva ; Peces-Barba, Germán ; de Torres, Juan P. ; Marín-Oto, Marta ; Calle, Myriam ; Golpe, Rafael ; Ojeda, Elena ; Divo, Miguel ; Pinto-Plata, Victor ; Amado, Carlos ; López-Campos, José Luis ; Celli, Bartolome R.
Resumen: Background
The value of the single-breath diffusing capacity of the lungs for carbon monoxide (Dlco) relates to outcomes for patients with COPD. However, little is known about the natural course of Dlco over time, intersubject variability, and factors that may influence Dlco progression.
Research Question
What is the natural course of Dlco in patients with COPD over time, and which other factors, including sex differences, could influence this progression?
Study Design and Methods
We phenotyped 602 smokers (women, 33%), of whom 506 (84%) had COPD and 96 (16%) had no airflow limitation. Lung function, including Dlco, was monitored annually over 5 years. A random coefficients model was used to evaluate Dlco changes over time.
Results
The mean (± SE) yearly decline in Dlco % in patients with COPD was 1.34% ± 0.015%/y. This was steeper compared with non-COPD control subjects (0.04% ± 0.032%/y; P = .004). Sixteen percent of the patients with COPD, vs 4.3% of the control subjects, had a statistically significant Dlco % slope annual decline (4.14%/y). At baseline, women with COPD had lower Dlco values (11.37% ± 2.27%; P < .001) in spite of a higher FEV1 % than men. Compared with men, women with COPD had a steeper Dlco annual decline of 0.89% ± 0.42%/y (P = .039).
Interpretation
Patients with COPD have an accelerated decline in Dlco compared with smokers without the disease. However, the decline is slow, and a testing interval of 3 to 4 years may be clinically informative. The lower and more rapid decline in Dlco values in women, compared with men, suggests a differential impact of sex in gas exchange function.
Idioma: Inglés
DOI: 10.1016/j.chest.2021.03.069
Año: 2021
Publicado en: Chest 160, 2 (2021), 481-490
ISSN: 0012-3692
Factor impacto JCR: 11.393 (2021)
Categ. JCR: CRITICAL CARE MEDICINE rank: 5 / 35 = 0.143 (2021) - Q1 - T1
Categ. JCR: RESPIRATORY SYSTEM rank: 6 / 66 = 0.091 (2021) - Q1 - T1
Factor impacto CITESCORE: 10.0 - Medicine (Q1)
Factor impacto SCIMAGO: 2.264 - Critical Care and Intensive Care Medicine (Q1) - Cardiology and Cardiovascular Medicine (Q1)
Tipo y forma: Artículo (PostPrint)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
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Exportado de SIDERAL (2025-01-16-14:32:26)
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The value of the single-breath diffusing capacity of the lungs for carbon monoxide (Dlco) relates to outcomes for patients with COPD. However, little is known about the natural course of Dlco over time, intersubject variability, and factors that may influence Dlco progression.
Research Question
What is the natural course of Dlco in patients with COPD over time, and which other factors, including sex differences, could influence this progression?
Study Design and Methods
We phenotyped 602 smokers (women, 33%), of whom 506 (84%) had COPD and 96 (16%) had no airflow limitation. Lung function, including Dlco, was monitored annually over 5 years. A random coefficients model was used to evaluate Dlco changes over time.
Results
The mean (± SE) yearly decline in Dlco % in patients with COPD was 1.34% ± 0.015%/y. This was steeper compared with non-COPD control subjects (0.04% ± 0.032%/y; P = .004). Sixteen percent of the patients with COPD, vs 4.3% of the control subjects, had a statistically significant Dlco % slope annual decline (4.14%/y). At baseline, women with COPD had lower Dlco values (11.37% ± 2.27%; P < .001) in spite of a higher FEV1 % than men. Compared with men, women with COPD had a steeper Dlco annual decline of 0.89% ± 0.42%/y (P = .039).
Interpretation
Patients with COPD have an accelerated decline in Dlco compared with smokers without the disease. However, the decline is slow, and a testing interval of 3 to 4 years may be clinically informative. The lower and more rapid decline in Dlco values in women, compared with men, suggests a differential impact of sex in gas exchange function.
Idioma: Inglés
DOI: 10.1016/j.chest.2021.03.069
Año: 2021
Publicado en: Chest 160, 2 (2021), 481-490
ISSN: 0012-3692
Factor impacto JCR: 11.393 (2021)
Categ. JCR: CRITICAL CARE MEDICINE rank: 5 / 35 = 0.143 (2021) - Q1 - T1
Categ. JCR: RESPIRATORY SYSTEM rank: 6 / 66 = 0.091 (2021) - Q1 - T1
Factor impacto CITESCORE: 10.0 - Medicine (Q1)
Factor impacto SCIMAGO: 2.264 - Critical Care and Intensive Care Medicine (Q1) - Cardiology and Cardiovascular Medicine (Q1)
Tipo y forma: Artículo (PostPrint)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
Debe reconocer adecuadamente la autoría, proporcionar un enlace a la licencia e indicar si se han realizado cambios. Puede hacerlo de cualquier manera razonable, pero no de una manera que sugiera que tiene el apoyo del licenciador o lo recibe por el uso que hace. No puede utilizar el material para una finalidad comercial. Si remezcla, transforma o crea a partir del material, no puede difundir el material modificado.Exportado de SIDERAL (2025-01-16-14:32:26)
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Registro creado el 2025-01-16, última modificación el 2025-01-16