Chest
Original ResearchCOPDNormal Bronchial Blood Flow in COPD Is Unaffected by Inhaled Corticosteroids and Correlates With Exhaled Nitric Oxide
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Patients
All the patients who were enrolled in the study met the Global Initiative for Chronic Obstructive Lung Disease criteria for the diagnosis of COPD19 and had moderate (n = 12) or severe (n = 5) disease severity with a moderate degree of emphysema, as assessed by the carbon monoxide transfer coefficient (Tlco) in 10 patients and CT scan in 4 patients. All of the patients were ex-smokers with a history of smoking equivalent to at least 20 pack-years. Active and passive smokers (ie, smoke exposure
QAW
QAW was not significantly different in patients with COPD (34.29 ± 1.09 μL/mL/min) compared to that in healthy subjects (35.50 ± 1.74 μL/mL/min; p > 0.05). In addition, QAW was not affected by long-term treatment with corticosteroids (treated patients, 35.89 ± 1.63; untreated patients, 32.50 ± 1.24 μL/mL/min; p < 0.05) [Fig 1]. QAW was not correlated with airway obstruction as assessed by FEV1; however, there was a positive correlation with Tlco (r = 0.74; p < 0.05) [see Fig 3, left, A].
Effect of Albuterol
Ten
Discussion
We have demonstrated that patients with COPD have a similar QAW compared to healthy subjects and reduced vascular reactivity. Furthermore, for the first time we found a positive correlation between QAW and FENO. We confirm that patients with COPD have an abnormal bronchial vascular reactivity that is steroid-resistant, and we suggest that treatment with NO may have a role in the regulation of QAW.
QAW was measured using the acetylene dilution method, as previously shown.5 This method is
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This research was supported by National Heart and Lung Institute, London UK.
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.