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BMC Pulmonary Medicine
Published in: BMC Pulmonary Medicine 1/2010

Open Access 01-12-2010 | Research article

Relationship between peripheral airway function and patient-reported outcomes in COPD: a cross-sectional study

Authors: Akane Haruna, Toru Oga, Shigeo Muro, Tadashi Ohara, Susumu Sato, Satoshi Marumo, Daisuke Kinose, Kunihiko Terada, Michiyoshi Nishioka, Emiko Ogawa, Yuma Hoshino, Toyohiro Hirai, Kazuo Chin, Michiaki Mishima

Published in: BMC Pulmonary Medicine | Issue 1/2010

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Abstract

Background

Health status, dyspnea and psychological status are important clinical outcomes in chronic obstructive pulmonary disease (COPD). However, forced expiratory volume in one second (FEV1) measured by spirometry, the standard measurement of airflow limitation, has only a weak relationship with these outcomes in COPD. Recently, in addition to spirometry, impulse oscillometry (IOS) measuring lung resistance (R) and reactance (X) is increasingly being used to assess pulmonary functional impairment.

Methods

We aimed to identify relationships between IOS measurements and patient-reported outcomes in 65 outpatients with stable COPD. We performed pulmonary function testing, IOS, high-resolution computed tomography (CT), and assessment of health status using the St. George's Respiratory Questionnaire (SGRQ), dyspnea using the Medical Research Council (MRC) scale and psychological status using the Hospital Anxiety and Depression Scale (HADS). We then investigated the relationships between these parameters. For the IOS measurements, we used lung resistance at 5 and 20 Hz (R5 and R20, respectively) and reactance at 5 Hz (X5). Because R5 and R20 are regarded as reflecting total and proximal airway resistance, respectively, the fall in resistance from R5 to R20 (R5-R20) was used as a surrogate for the resistance of peripheral airways. X5 was also considered to represent peripheral airway abnormalities.

Results

R5-R20 and X5 were significantly correlated with the SGRQ and the MRC. These correlation coefficients were greater than when using other objective measurements of pulmonary function, R20 on the IOS and CT instead of R5-R20 and X5. Multiple regression analyses showed that R5-R20 or X5 most significantly accounted for the SGRQ and MRC scores.

Conclusions

IOS measurements, especially indices of peripheral airway function, are significantly correlated with health status and dyspnea in patients with COPD. Therefore, in addition to its simplicity and non-invasiveness, IOS may be a useful clinical tool not only for detecting pulmonary functional impairment, but also to some extent at least estimating the patient's quality of daily life and well-being.
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Metadata
Title
Relationship between peripheral airway function and patient-reported outcomes in COPD: a cross-sectional study
Authors
Akane Haruna
Toru Oga
Shigeo Muro
Tadashi Ohara
Susumu Sato
Satoshi Marumo
Daisuke Kinose
Kunihiko Terada
Michiyoshi Nishioka
Emiko Ogawa
Yuma Hoshino
Toyohiro Hirai
Kazuo Chin
Michiaki Mishima
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2010
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/1471-2466-10-10

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