Prognostic implication of 1-year decline in diffusing capacity in newly diagnosed idiopathic pulmonary fibrosis
Abstract The progression of idiopathic pulmonary fibrosis (IPF) is assessed through serial monitoring of forced vital capacity (FVC). Currently, data regarding the clinical significance of longitudinal changes in diffusing capacity for carbon monoxide (DLCO) is lacking. We investigated the prognosti...
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| Format: | Article |
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Nature Portfolio
2024-04-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-024-59649-5 |
| _version_ | 1797199488043974656 |
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| author | Hyeonsu Lee So Yeon Kim Young Sik Park Sun Mi Choi Jong Hyuk Lee Jimyung Park |
| author_facet | Hyeonsu Lee So Yeon Kim Young Sik Park Sun Mi Choi Jong Hyuk Lee Jimyung Park |
| author_sort | Hyeonsu Lee |
| collection | DOAJ |
| description | Abstract The progression of idiopathic pulmonary fibrosis (IPF) is assessed through serial monitoring of forced vital capacity (FVC). Currently, data regarding the clinical significance of longitudinal changes in diffusing capacity for carbon monoxide (DLCO) is lacking. We investigated the prognostic implications of a 1-year decline in DLCO in 319 patients newly diagnosed with IPF at a tertiary hospital between January 2010 and December 2020. Changes in FVC and DLCO over the first year after the initial diagnosis were reviewed; a decline in FVC ≥ 5% and DLCO ≥ 10% predicted were considered significant changes. During the first year after diagnosis, a significant decline in FVC and DLCO was observed in 101 (31.7%) and 64 (20.1%) patients, respectively. Multivariable analysis showed that a 1-year decline in FVC ≥ 5% predicted (aHR 2.74, 95% CI 1.88–4.00) and 1-year decline in DLCO ≥ 10% predicted (aHR 2.31, 95% CI 1.47–3.62) were independently associated with a higher risk of subsequent mortality. The prognostic impact of a decline in DLCO remained significant regardless of changes in FVC, presence of emphysema, or radiographic indications of pulmonary hypertension. Therefore, serial monitoring of DLCO should be recommended because it may offer additional prognostic information compared with monitoring of FVC alone. |
| first_indexed | 2024-04-24T07:16:33Z |
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| id | doaj.art-a99ecdc533fe40abbf50fff01181f1db |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-24T07:16:33Z |
| publishDate | 2024-04-01 |
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| spelling | doaj.art-a99ecdc533fe40abbf50fff01181f1db2024-04-21T11:15:47ZengNature PortfolioScientific Reports2045-23222024-04-011411910.1038/s41598-024-59649-5Prognostic implication of 1-year decline in diffusing capacity in newly diagnosed idiopathic pulmonary fibrosisHyeonsu Lee0So Yeon Kim1Young Sik Park2Sun Mi Choi3Jong Hyuk Lee4Jimyung Park5Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University HospitalDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University HospitalDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University HospitalDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University HospitalDepartment of Radiology, Seoul National University HospitalDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University HospitalAbstract The progression of idiopathic pulmonary fibrosis (IPF) is assessed through serial monitoring of forced vital capacity (FVC). Currently, data regarding the clinical significance of longitudinal changes in diffusing capacity for carbon monoxide (DLCO) is lacking. We investigated the prognostic implications of a 1-year decline in DLCO in 319 patients newly diagnosed with IPF at a tertiary hospital between January 2010 and December 2020. Changes in FVC and DLCO over the first year after the initial diagnosis were reviewed; a decline in FVC ≥ 5% and DLCO ≥ 10% predicted were considered significant changes. During the first year after diagnosis, a significant decline in FVC and DLCO was observed in 101 (31.7%) and 64 (20.1%) patients, respectively. Multivariable analysis showed that a 1-year decline in FVC ≥ 5% predicted (aHR 2.74, 95% CI 1.88–4.00) and 1-year decline in DLCO ≥ 10% predicted (aHR 2.31, 95% CI 1.47–3.62) were independently associated with a higher risk of subsequent mortality. The prognostic impact of a decline in DLCO remained significant regardless of changes in FVC, presence of emphysema, or radiographic indications of pulmonary hypertension. Therefore, serial monitoring of DLCO should be recommended because it may offer additional prognostic information compared with monitoring of FVC alone.https://doi.org/10.1038/s41598-024-59649-5Idiopathic pulmonary fibrosisPulmonary diffusing capacityVital capacityDisease progressionRespiratory function test |
| spellingShingle | Hyeonsu Lee So Yeon Kim Young Sik Park Sun Mi Choi Jong Hyuk Lee Jimyung Park Prognostic implication of 1-year decline in diffusing capacity in newly diagnosed idiopathic pulmonary fibrosis Scientific Reports Idiopathic pulmonary fibrosis Pulmonary diffusing capacity Vital capacity Disease progression Respiratory function test |
| title | Prognostic implication of 1-year decline in diffusing capacity in newly diagnosed idiopathic pulmonary fibrosis |
| title_full | Prognostic implication of 1-year decline in diffusing capacity in newly diagnosed idiopathic pulmonary fibrosis |
| title_fullStr | Prognostic implication of 1-year decline in diffusing capacity in newly diagnosed idiopathic pulmonary fibrosis |
| title_full_unstemmed | Prognostic implication of 1-year decline in diffusing capacity in newly diagnosed idiopathic pulmonary fibrosis |
| title_short | Prognostic implication of 1-year decline in diffusing capacity in newly diagnosed idiopathic pulmonary fibrosis |
| title_sort | prognostic implication of 1 year decline in diffusing capacity in newly diagnosed idiopathic pulmonary fibrosis |
| topic | Idiopathic pulmonary fibrosis Pulmonary diffusing capacity Vital capacity Disease progression Respiratory function test |
| url | https://doi.org/10.1038/s41598-024-59649-5 |
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