Prediction of air trapping or pulmonary hyperinflation by forced spirometry in COPD patients: results from COSYCONET
Background Air trapping and lung hyperinflation are major determinants of prognosis and response to therapy in chronic obstructive pulmonary disease (COPD). They are often determined by body plethysmography, which has limited availability, and so the question arises as to what extent they can be est...
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| Format: | Article |
| Language: | English |
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European Respiratory Society
2020-07-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/6/3/00092-2020.full |
| _version_ | 1819072188325560320 |
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| author | Peter Alter Jan Orszag Christina Kellerer Kathrin Kahnert Tim Speicher Henrik Watz Robert Bals Tobias Welte Claus F. Vogelmeier Rudolf A. Jörres COSYCONET study group: S. Andreas R. Bals J. Behr K. Kahnert B. Bewig R. Buhl R. Ewert B. Stubbe J.H. Ficker M. Gogol C. Grohé R. Hauck M. Held B. Jany M. Henke F.J.F. Herth G. Höffken H.A. Katus A.-M. Kirsten H. Watz R. Koczulla K. Kenn J. Kronsbein C. Kropf-Sanchen C. Lange P. Zabel M.W.J. Randerath W. Seeger M. Studnicka C. Taube H. Teschler H. Timmermann J.C. Virchow C. Vogelmeier U. Wagner T. Welte H. Wirtz |
| author_facet | Peter Alter Jan Orszag Christina Kellerer Kathrin Kahnert Tim Speicher Henrik Watz Robert Bals Tobias Welte Claus F. Vogelmeier Rudolf A. Jörres COSYCONET study group: S. Andreas R. Bals J. Behr K. Kahnert B. Bewig R. Buhl R. Ewert B. Stubbe J.H. Ficker M. Gogol C. Grohé R. Hauck M. Held B. Jany M. Henke F.J.F. Herth G. Höffken H.A. Katus A.-M. Kirsten H. Watz R. Koczulla K. Kenn J. Kronsbein C. Kropf-Sanchen C. Lange P. Zabel M.W.J. Randerath W. Seeger M. Studnicka C. Taube H. Teschler H. Timmermann J.C. Virchow C. Vogelmeier U. Wagner T. Welte H. Wirtz |
| author_sort | Peter Alter |
| collection | DOAJ |
| description | Background
Air trapping and lung hyperinflation are major determinants of prognosis and response to therapy in chronic obstructive pulmonary disease (COPD). They are often determined by body plethysmography, which has limited availability, and so the question arises as to what extent they can be estimated via spirometry.
Methods
We used data from visits 1–5 of the COPD cohort COSYCONET. Predictive parameters were derived from visit 1 data, while visit 2–5 data was used to assess reproducibility. Pooled data then yielded prediction models including sex, age, height, and body mass index as covariates. Hyperinflation was defined as ratio of residual volume (RV) to total lung capacity (TLC) above the upper limit of normal. (ClinicalTrials.gov identifier: NCT01245933).
Results
Visit 1 data from 1988 patients (Global Initiative for Chronic Obstructive Lung Disease grades 1–4, n=187, 847, 766, 188, respectively) were available for analysis (n=1231 males, 757 females; mean±sd age 65.1±8.4 years; forced expiratory volume in 1 s (FEV1) 53.1±18.4 % predicted (% pred); forced vital capacity (FVC) 78.8±18.8 % pred; RV/TLC 0.547±0.107). In total, 7157 datasets were analysed. Among measures of hyperinflation, RV/TLC showed the closest relationship to FEV1 % pred and FVC % pred, which were sufficient for prediction. Their relationship to RV/TLC could be depicted in nomograms. Even when neglecting covariates, hyperinflation was predicted by FEV1 % pred, FVC % pred or their combination with an area under the curve of 0.870, 0.864 and 0.889, respectively.
Conclusions
The degree of air trapping/hyperinflation in terms of RV/TLC can be estimated in a simple manner from forced spirometry, with an accuracy sufficient for inferring the presence of hyperinflation. This may be useful for clinical settings, where body plethysmography is not available. |
| first_indexed | 2024-12-21T17:33:45Z |
| format | Article |
| id | doaj.art-9e668ef3fc214a9d872c716f58769ae0 |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-12-21T17:33:45Z |
| publishDate | 2020-07-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-9e668ef3fc214a9d872c716f58769ae02022-12-21T18:55:50ZengEuropean Respiratory SocietyERJ Open Research2312-05412020-07-016310.1183/23120541.00092-202000092-2020Prediction of air trapping or pulmonary hyperinflation by forced spirometry in COPD patients: results from COSYCONETPeter Alter0Jan Orszag1Christina Kellerer2Kathrin Kahnert3Tim Speicher4Henrik Watz5Robert Bals6Tobias Welte7Claus F. Vogelmeier8Rudolf A. Jörres9COSYCONET study group:S. AndreasR. BalsJ. BehrK. KahnertB. BewigR. BuhlR. EwertB. StubbeJ.H. FickerM. GogolC. GrohéR. HauckM. HeldB. JanyM. HenkeF.J.F. HerthG. HöffkenH.A. KatusA.-M. KirstenH. WatzR. KoczullaK. KennJ. KronsbeinC. Kropf-SanchenC. LangeP. ZabelM.W.J. RanderathW. SeegerM. StudnickaC. TaubeH. TeschlerH. TimmermannJ.C. VirchowC. VogelmeierU. WagnerT. WelteH. Wirtz Dept of Medicine, Pulmonary and Critical Care Medicine, Philipps University of Marburg (UMR), member of the German Center for Lung Research (DZL), Marburg, Germany Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Comprehensive Pneumology Center Munich (CPC-M), member of the DZL, Munich, Germany School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany Dept of Internal Medicine V, University Hospital, LMU Munich, CPC-M, member of the DZL, Munich, Germany Dept of Medicine, Pulmonary and Critical Care Medicine, Philipps University of Marburg (UMR), member of the German Center for Lung Research (DZL), Marburg, Germany Pulmonary Research Institute at LungenClinic Grosshansdorf, Airway Research Center North, member of the DZL, Grosshansdorf, Germany Dept of Internal Medicine V – Pulmonology, Allergology, Intensive Care Medicine, Saarland University Hospital, Homburg, Germany Clinic for Pneumology, Hannover Medical School, member of the DZL, Hannover, Germany Dept of Medicine, Pulmonary and Critical Care Medicine, Philipps University of Marburg (UMR), member of the German Center for Lung Research (DZL), Marburg, Germany Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Comprehensive Pneumology Center Munich (CPC-M), member of the DZL, Munich, Germany Background Air trapping and lung hyperinflation are major determinants of prognosis and response to therapy in chronic obstructive pulmonary disease (COPD). They are often determined by body plethysmography, which has limited availability, and so the question arises as to what extent they can be estimated via spirometry. Methods We used data from visits 1–5 of the COPD cohort COSYCONET. Predictive parameters were derived from visit 1 data, while visit 2–5 data was used to assess reproducibility. Pooled data then yielded prediction models including sex, age, height, and body mass index as covariates. Hyperinflation was defined as ratio of residual volume (RV) to total lung capacity (TLC) above the upper limit of normal. (ClinicalTrials.gov identifier: NCT01245933). Results Visit 1 data from 1988 patients (Global Initiative for Chronic Obstructive Lung Disease grades 1–4, n=187, 847, 766, 188, respectively) were available for analysis (n=1231 males, 757 females; mean±sd age 65.1±8.4 years; forced expiratory volume in 1 s (FEV1) 53.1±18.4 % predicted (% pred); forced vital capacity (FVC) 78.8±18.8 % pred; RV/TLC 0.547±0.107). In total, 7157 datasets were analysed. Among measures of hyperinflation, RV/TLC showed the closest relationship to FEV1 % pred and FVC % pred, which were sufficient for prediction. Their relationship to RV/TLC could be depicted in nomograms. Even when neglecting covariates, hyperinflation was predicted by FEV1 % pred, FVC % pred or their combination with an area under the curve of 0.870, 0.864 and 0.889, respectively. Conclusions The degree of air trapping/hyperinflation in terms of RV/TLC can be estimated in a simple manner from forced spirometry, with an accuracy sufficient for inferring the presence of hyperinflation. This may be useful for clinical settings, where body plethysmography is not available.http://openres.ersjournals.com/content/6/3/00092-2020.full |
| spellingShingle | Peter Alter Jan Orszag Christina Kellerer Kathrin Kahnert Tim Speicher Henrik Watz Robert Bals Tobias Welte Claus F. Vogelmeier Rudolf A. Jörres COSYCONET study group: S. Andreas R. Bals J. Behr K. Kahnert B. Bewig R. Buhl R. Ewert B. Stubbe J.H. Ficker M. Gogol C. Grohé R. Hauck M. Held B. Jany M. Henke F.J.F. Herth G. Höffken H.A. Katus A.-M. Kirsten H. Watz R. Koczulla K. Kenn J. Kronsbein C. Kropf-Sanchen C. Lange P. Zabel M.W.J. Randerath W. Seeger M. Studnicka C. Taube H. Teschler H. Timmermann J.C. Virchow C. Vogelmeier U. Wagner T. Welte H. Wirtz Prediction of air trapping or pulmonary hyperinflation by forced spirometry in COPD patients: results from COSYCONET ERJ Open Research |
| title | Prediction of air trapping or pulmonary hyperinflation by forced spirometry in COPD patients: results from COSYCONET |
| title_full | Prediction of air trapping or pulmonary hyperinflation by forced spirometry in COPD patients: results from COSYCONET |
| title_fullStr | Prediction of air trapping or pulmonary hyperinflation by forced spirometry in COPD patients: results from COSYCONET |
| title_full_unstemmed | Prediction of air trapping or pulmonary hyperinflation by forced spirometry in COPD patients: results from COSYCONET |
| title_short | Prediction of air trapping or pulmonary hyperinflation by forced spirometry in COPD patients: results from COSYCONET |
| title_sort | prediction of air trapping or pulmonary hyperinflation by forced spirometry in copd patients results from cosyconet |
| url | http://openres.ersjournals.com/content/6/3/00092-2020.full |
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