Relationship between Emphysema Quantification
and COPD Severity
Nitipatana Chierakul MD*,
Saowaluk Phanphongsiri MD*, Benjamas Chuaychoo MD*,
Nisa Muangman MD**, Kanyarat Totanarungroj MD**
Affiliation :
* Division of Respiratory Disease and Tuberculosis, Department of Medicine, Faculty of Medicine Siriraj Hospital,
Mahidol University, Bangkok, Thailand
** Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To determine the association between emphysema extent from high-resolution computed tomography (HRCT)
and the physiological derangement in patients with chronic obstructive pulmonary disease (COPD).
Material and Method: A cross-sectional study was undertaken to quantify the emphysema severity in 23 COPD patients
by automated HRCT scoring techniques. Correlation with phenotypic characters in term of exercise capacity [Modified
Medical Research Council (mMRC) dyspnea scale, and 6-minute walk distance (6MWD)], pulmonary function testing
[spirometry (forced expiratory volume in 1 second, FEV1 and forced vital capacity, FVC), and diffusing capacity (DLCO)],
were then assessed.
Results : Nineteen patients were male and four were female, the mean age was 738 years, with the mean FEV1 %predicted
of 67.825.4. Percentage of inspiratory emphysematous lung volume (%ELVi) had significant negative correlation with
%FEV1/FVC (r = -0.50, p = 0.016) and DLCO (r = 0.58, p = 0.011). Percentage of expiratory emphysematous lung volumes
(%ELVe) also had the same correlation with %FEV1/FVC (r = -0.58, p = 0.004) and DLCO (r = 0.48, p = 0.042). In addition,
%ELVe also had significant negative correlation with 6MWD (r = 0.50, p = 0.016), but had significant positive correlation
with mMRC scale (r = 0.53, p = 0.01).
Conclusion : Severity of emphysema assessed by HRCT was well correlated with pulmonary function test results and exercise
capacity. It can be used as one aspect of phenotypic characters in patients with COPD, for designing personalize management
plan.
Keywords : Emphysema quantification, COPD phenotype
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