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Casara A, Turato G, Marin-Oto M, Semenzato U, Biondini D, Tinè M, Bernardinello N, Cocconcelli E, Cubero P, Balestro E, Spagnolo P, Marin JM, Cosio MG, Saetta M, Bazzan E. Chronic Bronchitis Affects Outcomes in Smokers without Chronic Obstructive Pulmonary Disease (COPD). J Clin Med 2022; 11:jcm11164886. [PMID: 36013126 PMCID: PMC9410001 DOI: 10.3390/jcm11164886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
Background. Chronic bronchitis (CB) importantly affects outcomes in smokers with COPD, but the effects on smokers without COPD are less well known and less emphasized. The aim of our study was to investigate the possible effects of CB on clinical outcomes in smokers without COPD (noCOPD) and compare them with the effects in smokers with COPD (COPD). Methods. For that purpose, we studied 511 smokers, 302 with and 209 without COPD, followed for 10 years in an academic COPD ambulatory setting. Chronic bronchitis was defined as the presence of cough and sputum production for at least 3 months in each of two consecutive years. All subjects underwent clinical and functional examination with spirometry, diffusion capacity (DLco), 6-min walking test (6MWT), mMRC Dyspnoea Scale, COPD Assessment Test (CAT), and recording of annual frequency of exacerbations. All-cause mortality during follow-up was recorded. Results. 27% of noCOPD and 45% of COPD had CB. noCOPD with CB had lower FEV1 and DLco, worse 6MWT, more dyspnoea, a higher number of exacerbations and lower survival than noCOPD without CB. CB did not affect FEV1 decline in noCOPD but it significantly did in COPD. Conclusions. The presence of chronic bronchitis in smokers without COPD will significantly affect symptoms, quality of life, and survival, underlining the importance of recognizing the condition and managing it accordingly.
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Affiliation(s)
- Alvise Casara
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Graziella Turato
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Marta Marin-Oto
- Respiratory Service, Hospital Clinico Universitario, 50009 Zaragoza, Spain
| | - Umberto Semenzato
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Davide Biondini
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Mariaenrica Tinè
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Nicol Bernardinello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Elisabetta Cocconcelli
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Pablo Cubero
- Translational Research Unit (IIS Aragón), Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain
| | - Elisabetta Balestro
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Paolo Spagnolo
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Josè M. Marin
- Translational Research Unit (IIS Aragón), Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain
- Department of Medicine, University of Zaragoza School of Medicine, 50009 Zaragoza, Spain
| | - Manuel G. Cosio
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
- Meakins-Christie Laboratories, Respiratory Division, McGill University, Montreal, QU 000004, Canada
| | - Marina Saetta
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Erica Bazzan
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
- Correspondence:
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Bazzan E, Semenzato U, Turato G, Biondini D, Cubero P, Marin-Oto M, Forner M, Tinè M, Casara A, Baraldo S, Spagnolo P, Marin JM, Saetta M, Cosio MG. Symptomatic smokers without COPD have physiological changes heralding the development of COPD. ERJ Open Res 2022; 8:00202-2022. [PMID: 35769419 PMCID: PMC9234424 DOI: 10.1183/23120541.00202-2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 05/12/2022] [Indexed: 11/18/2022] Open
Abstract
Background COPD is a major health problem, mainly due to cigarette smoking. Most studies in COPD are dedicated to fully developed COPD in older subjects, even though development of COPD may start soon after smoking initiation. Therefore, there is a need to diagnose this “early disease” by detecting the initial events responsible for ultimate development of COPD. Methods Measurement of maximum mid expiratory flow between 25 and 75% of vital capacity (MMEF) in a routine spirometry, which detects small airways disease, was used to investigate if MMEF abnormalities in smokers without COPD (noCOPD) would relate to respiratory symptoms and identify smokers that might progress to COPD. For this purpose we studied 511 smokers, 302 COPD and 209 noCOPD, followed long term with spirometry including MMEF, diffusing capacity of the lung for carbon monoxide (DLCO), 6-min walk test (6MWT), Medical Research Council Dyspnoea Scale and COPD Assessment Test. Three spirometries V1,V2 and V3 (5±2.5 and 10±4 years apart from V1) were performed to assess functional decline and development of COPD. Results 65% of noCOPD had an abnormal MMEF (<80%) and 38% an abnormal DLCO. The NoCOPD with MMEF <80% group performed worse in the 6MWT (p=0.01), was more dyspnoeic (p=0.01) and had higher prevalence of chronic bronchitis than the noCOPD with MMEF>80% group (p=0.04). 21% of noCOPD with MMEF <80% and 2.7% with MMEF>80% developed COPD by V3 (p=0.0004). Conclusions The MMEF, a functional test available in a routine spirometry, can detect early lung abnormalities and identify the subset of symptomatic smokers with pathological changes that might lead to COPD. In symptomatic smokers with normal FEV1/FVC, an abnormal FEF25–75% (MMEF), which reflects early lung abnormalities, could be used as a biomarker for disease progression and impending risk of COPD developmenthttps://bit.ly/39y0smC
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Affiliation(s)
- Erica Bazzan
- Dept of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy.,Joint first authors
| | - Umberto Semenzato
- Dept of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy.,Joint first authors
| | - Graziella Turato
- Dept of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | - Davide Biondini
- Dept of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | - Pablo Cubero
- Unidad de Investigación Traslacional, IISAragon, Zaragoza, Spain.,Servicio de Neumología, Hospital Universitario Miguel Servet, IISAragon, Zaragoza, Spain
| | - Marta Marin-Oto
- Unidad de Investigación Traslacional, IISAragon, Zaragoza, Spain.,Servicio de Neumología, Hospital Universitario Miguel Servet, IISAragon, Zaragoza, Spain
| | - Marta Forner
- Unidad de Investigación Traslacional, IISAragon, Zaragoza, Spain.,Servicio de Neumología, Hospital Universitario Miguel Servet, IISAragon, Zaragoza, Spain
| | - Mariaenrica Tinè
- Dept of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | - Alvise Casara
- Dept of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | - Simonetta Baraldo
- Dept of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | - Paolo Spagnolo
- Dept of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | - Jose M Marin
- Unidad de Investigación Traslacional, IISAragon, Zaragoza, Spain.,Servicio de Neumología, Hospital Universitario Miguel Servet, IISAragon, Zaragoza, Spain
| | - Marina Saetta
- Dept of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy.,Joint senior authors
| | - Manuel G Cosio
- Dept of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy.,Meakins-Christie Laboratories, Respiratory Division, McGill University, Montreal, QC, Canada.,Joint senior authors
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杨 洁, 付 红, 白 涛, 王 凡, 张 欧, 张 曙, 聂 文. [Pulmonary ventilation function parameters of children aged 5-14 years in Kunming, China: a comparative analysis of measured values versus predicted values based on Zapletal equation]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020; 22:1313-1319. [PMID: 33328003 PMCID: PMC7735926 DOI: 10.7499/j.issn.1008-8830.2007185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/30/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To study the percentage of the measured values of the main pulmonary ventilation function parameters in their predicted values based on Zapletal equation among healthy children aged 5-14 years in Kunming, China, and to provide a basis for accurate judgment of pulmonary ventilation function in clinical practice. METHODS A total of 702 healthy children aged 5-14 years (352 boys and 350 girls) from Kunming were enrolled. The Jaeger spirometer was used to measure the nine indices:forced vital capacity (FVC), forced expiratory volume in one second (FEV1), ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC), maximal mid-expiratory flow (MMEF), forced expiratory flow at 25% of forced vital capacity (FEF25), forced expiratory flow at 50% of forced vital capacity (FEF50), forced expiratory flow at 75% of forced vital capacity (FEF75), peak expiratory flow (PEF), and maximal voluntary ventilation (MVV). The values obtained from the Zapletal equation of predicted values provided by the spirometer were used as the predicted values of children, and the percentage of measured values in predicted values was calculated. RESULTS In the 702 children, the percentages of the measured values of the main pulmonary ventilation function parameters PEF, FVC, FEV1, FEV1/FVC, and MVV in their predicted values fluctuated from 102% to 114%, 94% to 108%, 98% to 113%, 98% to 107%, and 141% to 183% respectively. As for the main airway velocity parameters, the percentages of the measured values of FEF25, FEF50, FEF75, and MMEF in their predicted values fluctuated from 98% to 116%, 85% to 102%, 71% to 98%, and 83% to 100% respectively. The percentages of the measured values of PEF, FVC, FEV1, FEV1/FVC, MVV, FEF25, FEF50, FEF75, and MMEF in their predicted values had the lower limits of normal of 88.2%, 88.4%, 92.0%, 94.4%, 118.5%, 82.9%, 70.0%, 62.1%, and 70.1% respectively. CONCLUSIONS There are differences between pulmonary ventilation function parameter levels and normal values provided by Zapletal equation in healthy children aged 5-14 years in Kunming. As for the pulmonary ventilation function parameters of PEF, FVC, FEV, FEV1/FVC, MVV, FEF25, FEF50, FEF75, and MMEF in these children, the lower limits of normal of measured values in predicted values may be determined as 88.2%, 88.4%, 92.0%, 94.4%, 118.5%, 82.9%, 70.0%, 62.1%, and 70.1% respectively.
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Affiliation(s)
- 洁 杨
- 昆明医科大学附属儿童医院呼吸与危重症医学科, 云南 昆明 650032Department of Respiratory and Critical Diseases, Children's Hospital of Kunming Medical University, Kunming 650032, China
| | - 红敏 付
- 昆明医科大学附属儿童医院呼吸与危重症医学科, 云南 昆明 650032Department of Respiratory and Critical Diseases, Children's Hospital of Kunming Medical University, Kunming 650032, China
| | - 涛珍 白
- 云南财经大学大数据研究院, 云南 昆明 650221
| | - 凡 王
- 昆明医科大学附属儿童医院呼吸与危重症医学科, 云南 昆明 650032Department of Respiratory and Critical Diseases, Children's Hospital of Kunming Medical University, Kunming 650032, China
| | - 欧 张
- 昆明医科大学附属儿童医院呼吸与危重症医学科, 云南 昆明 650032Department of Respiratory and Critical Diseases, Children's Hospital of Kunming Medical University, Kunming 650032, China
| | - 曙冬 张
- 昆明医科大学附属儿童医院呼吸与危重症医学科, 云南 昆明 650032Department of Respiratory and Critical Diseases, Children's Hospital of Kunming Medical University, Kunming 650032, China
| | - 文莎 聂
- 昆明医科大学附属儿童医院呼吸与危重症医学科, 云南 昆明 650032Department of Respiratory and Critical Diseases, Children's Hospital of Kunming Medical University, Kunming 650032, China
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