Decline in Carbon Monoxide Transfer Coefficient in Chronic Obstructive Pulmonary Disease
Autor: | Deog-Kyeom Kim, Ki Uk Kim, Hun-Gyu Hwang, Yeon-Mok Oh, Chang Hoon Lee, Sang Do Lee, Yeon Wook Kim, Yu-Il Kim, Sang Haak Lee |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Exacerbation lcsh:Medicine Pulmonary disease Rate ratio Article chronic obstructive pulmonary disease 03 medical and health sciences FEV1/FVC ratio 0302 clinical medicine exacerbation Internal medicine medicine 030212 general & internal medicine COPD business.industry Incidence (epidemiology) lung function decline lcsh:R carbon monoxide transfer coefficient General Medicine respiratory system medicine.disease Obstructive lung disease respiratory tract diseases 030228 respiratory system Cohort Cardiology business |
Zdroj: | Journal of Clinical Medicine Volume 9 Issue 5 Journal of Clinical Medicine, Vol 9, Iss 1512, p 1512 (2020) |
ISSN: | 2077-0383 |
DOI: | 10.3390/jcm9051512 |
Popis: | Background: Although a reduced carbon monoxide transfer coefficient (Kco) is an important feature in chronic obstructive pulmonary disease (COPD), how it changes over time and its relationship with other clinical outcomes remain unclear. This study evaluated longitudinal changes in Kco and their relationship with other clinical outcomes. Methods: We evaluated patients with COPD from the Korean Obstructive Lung Disease cohort, followed up for up to ten years. Random coefficient models were used to assess the annual change in Kco over time. Participants were categorized into tertiles according to Kco decline rate. Baseline characteristics and outcomes, including changes in FEV1 and emphysema index, incidence of exacerbations, and mortality, were compared between categories. Results: A decline in Kco was observed in 92.9% of the 211 enrolled participants with COPD. Those with the most rapid decline (tertile 1) had a lower FEV1/FVC% (tertile 1: 43.8% ± 9.7%, tertile 2: 46.4% ± 10.5%, tertile 3: 49.2% ± 10.4%, p = 0.008) and a higher emphysema index at baseline (27.7 ± 14.8, 22.4 ± 16.1, 18.1 ± 14.5, respectively, p = 0.001). Tertile 3 showed a lower decline rate in FEV1 (16.3 vs. 27.1 mL/yr, p = 0.017) and a lower incidence of exacerbations (incidence rate ratio = 0.66, 95% CI = 0.44&ndash 0.99) than tertile 1. There were no differences in the change in emphysema index and mortality between categories. Conclusion: Most patients with COPD experienced Kco decline over time, which was greater in patients with more severe airflow limitation and emphysema. Decline in Kco was associated with an accelerated decline in FEV1 and more frequent exacerbations hence, this should be considered as an important outcome measure in further studies. |
Databáze: | OpenAIRE |
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