Article Text

Download PDFPDF

Chronic obstructive pulmonary disease: measuring disease progression

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


RI Carter, AM Wood, RA Stockley. University Hospital Birmingham NHS Foundation Trust, Birmingham, UK

Introduction and Objectives: Chronic obstructive pulmonary disease (COPD) is characterised by airflow limitation with a post-bronchodilator FEV1 : FVC less than 0.7.1 Reversibility (post-bronchodilator increase in FEV1 of 12% and 200 ml)1 is still used to exclude a diagnosis of COPD;2 however, recent baseline data from the UPLIFT trial have shown that the majority of patients with COPD fulfil these criteria.3 An increase of 400 ml is considered clinically significant,1 is highly suggestive of asthma and should be treated as such.4 The current study explores the relationship between spirometric bronchodilator response and other lung function tests and computed tomography (CT) scans in patients with a diagnosis of COPD including a 4-year follow-up.

Methods: The study population consists of well-characterised patients with post-bronchodilator FEV1 : FVC less than 0.7 and clinical features of COPD. Full lung function tests and CT analysis (presence of visible emphysema and densitometry) were performed at baseline and at 4 years. The results of these were compared for three groups based on FEV1 increase post-bronchodilator: A <200 ml or <12%; B >12% and >200 ml but <400 ml; C >400 ml.

View this table:
Abstract S86 Table

Results: There was no significant difference in smoking status, gender or age between the three groups. However, group C had a significantly greater baseline FEV1 (% predicted) and absolute decline in FEV1 but a lesser decline in lower zone voxel index and KCO (% predicted). In addition, group C had a greater decline in FEV1 (% predicted), although this just fell short of the criteria for significance relative to group B (p = 0.058). The results are summarised in the table.

Conclusions: The majority of patients in this study exhibited a …

View Full Text