E pluribus plurima: Multidimensional indices and clinical phenotypes in COPD

Excerpt

Chronic Obstructive Pulmonary Disease (COPD) is a disorder of the respiratory system characterized by progressive and only partially reversible airflow obstruction, due to a varying combination of large (bronchitis) and small airways (small airway disease) damage, and lung parenchymal and vascular destruction [1]. We prefer the term obstruction to airflow limitation because the latter is a physiologic event which occurs also in normals at high levels of ventilation, for example during exercise. The correct definition should be "excessive airflow limitation" to indicate that the reduction in airflow occurs at lower level of ventilation than in normal condition. The diagnostic procedure for COPD starts from the recognition of risk factors (cigarette smoking "in primis", but also outdoor and indoor air pollution [2]) and the presence of symptoms such as chronic cough and phlegm and reduced exercise tolerance. The lifestyle is important for the reveal of symptoms: dyspnea occurs later in a sedentary person than in an active individual. …