Functional respiratory imaging: heterogeneity of acute exacerbations of COPD

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Title: Functional respiratory imaging: heterogeneity of acute exacerbations of COPD
Author(s): Van Geffen, WH
Hajian, B
Vos, W
De Backer, J
Cahn, A
Usmani, OS
Van Holsbeke, C
Pistolesi, M
Kerstjens, HA
De Backer, W
Item Type: Journal Article
Abstract: Background: Exacerbations of COPD are a major burden to patients, and yet little is understood about heterogeneity. It contributes to the current persistent one-size-fits-all treatment. To replace this treatment by more personalized, precision medicine, new insights are required. We assessed the heterogeneity of exacerbations by functional respiratory imaging (FRI) in 3-dimensional models of airways and lungs. Methods: The trial was designed as a multicenter trial of patients with an acute exacerbation of COPD who were assessed by FRI, pulmonary function tests, and patient-reported outcomes, both in the acute stage and during resolution. Results: Forty seven patients were assessed. FRI analyses showed significant improvements in hyperinflation (a decrease in total volume at functional residual capacity of -0.25±0.61 L, p≤0.01), airway volume at total lung capacity (+1.70±4.65 L, p=0.02), and airway resistance. As expected, these improvements correlated partially with changes in the quality of life and in conventional lung function test parameters. Patients with the same changes in pulmonary function differ in regional disease activity measured by FRI. Conclusion: FRI is a useful tool to get a better insight into exacerbations of COPD, and significant improvements in its indices can be demonstrated from the acute phase to resolution even in relatively small groups. It clearly visualizes the marked variability within and between individuals in ventilation and resistance during exacerbations and is a tool for the assessment of the heterogeneity of COPD exacerbations.
Publication Date: 30-May-2018
Date of Acceptance: 13-Feb-2018
URI: http://hdl.handle.net/10044/1/61400
DOI: https://dx.doi.org/10.2147/COPD.S152463
ISSN: 1176-9106
Publisher: Dove Medical Press
Start Page: 1783
End Page: 1792
Journal / Book Title: International Journal of Chronic Obstructive Pulmonary Disease
Volume: 13
Copyright Statement: © 2018 van Geffen et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
Keywords: COPD exacerbations
FRI
chronic obstructive pulmonary disease
heterogeneity
hyperinflation
symptoms
COPD exacerbations
FRI
chronic obstructive pulmonary disease
heterogeneity
hyperinflation
symptoms
1102 Cardiovascular Medicine And Haematology
Respiratory System
Publication Status: Published
Conference Place: New Zealand
Online Publication Date: 2018-05-30
Appears in Collections:National Heart and Lung Institute
Airway Disease
Faculty of Medicine



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