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: Article (PostPrint)
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. If you remix, transform, or build upon the material, you may not distribute the modified material.
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: Article (PostPrint)
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. If you remix, transform, or build upon the material, you may not distribute the modified material. Exportado de SIDERAL (2025-01-16-14:32:26)
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Record created 2025-01-16, last modified 2025-01-16