Functional and radiological characteristics of asthma combined chronic obstructive pulmonary disease overlap

Abstract Background Persons with asthma–chronic obstructive pulmonary disease (COPD) overlap (ACO) are a crucial but poorly characterized group. In spite of the numbers of patients with ACO have increased, there is minimal confirmed evidence regarding diagnostic features and choices of treatment. So...

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Main Authors: Hamada K. Fayed, Yasen G. Abd-Elkareem, Wassem A. Samaha, Maher S. Abdalshakour
Format: Article
Language:English
Published: SpringerOpen 2020-01-01
Series:The Egyptian Journal of Bronchology
Subjects:
Online Access:https://doi.org/10.4103/ejb.ejb_14_19
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author Hamada K. Fayed
Yasen G. Abd-Elkareem
Wassem A. Samaha
Maher S. Abdalshakour
author_facet Hamada K. Fayed
Yasen G. Abd-Elkareem
Wassem A. Samaha
Maher S. Abdalshakour
author_sort Hamada K. Fayed
collection DOAJ
description Abstract Background Persons with asthma–chronic obstructive pulmonary disease (COPD) overlap (ACO) are a crucial but poorly characterized group. In spite of the numbers of patients with ACO have increased, there is minimal confirmed evidence regarding diagnostic features and choices of treatment. So, the aim of this study was to identify the physiological and radiological characteristics of patients with ACO. Patients and methods This study was performed on 200 patients classified into 38 patients diagnosed as having asthma, 132 patients diagnosed as having COPD, and 30 patients diagnosed as having ACO, who were chosen based on clinical features. All patients underwent pulmonary function tests, and multislice computed tomography imaging. Results The mean age of our study population was 61 years. The mean age in COPD group was higher compared with asthma and ACO groups (63.9±7.8 vs. 44.84±12.2 and 56.7 ±8, respectively), with a predominance of males in COPD and females in asthma, with a higher smoking index in patients with COPD than those with ACO and asthma (47.05±37.7, 13.53±2.2, and 2.47±1.46, respectively). Measurements of forced expiratory volume in 1 s (FEV1) by liters before bronchodilator therapy is greater in patients with asthma than ACO and COPD groups (1.89±0.42, 1.52±0.39, and 1.35 ±0.4, respectively), with highly significant difference (P<0.001). With airway reversibility, it is also greater in patients with asthma than ACO and COPD groups (2.85 ±0.49, 1.99±0.47, and 1.41±0.39, respectively), with a highly significant difference (P<0.001). Airway internal diameter of patients with COPD is greater than ACO and asthma groups (4.03±0.3, 3.92±0.17, and 2.82±0.31, respectively), with a highly significant difference (P<0.001). On the contrary, airway external diameter of patients with COPD is greater than asthma and ACO groups, with a highly significant difference (P<0.001). Airway wall thickness of patients with asthma is greater than ACO and COPD groups, with a highly statistical difference (P<0.001). There is no relation between thickness of airway wall and airway obstruction, expressed as FEV1 %predicted, in patients with asthma and COPD. This study results confirmed the correlation between the thickness of airway wall and airway obstruction, expressed as FEV1 % predicted, in patients with ACO. Conclusion Bronchial wall thickness measured by chest high resolution computed tomography (HRCT) is increased in patients with asthma than those with ACO and COPD, with a high statistical significance.
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spelling doaj.art-cdfda63b1785471eb143a44ae58d99622022-12-21T20:38:15ZengSpringerOpenThe Egyptian Journal of Bronchology1687-84262314-85512020-01-0113559660410.4103/ejb.ejb_14_19Functional and radiological characteristics of asthma combined chronic obstructive pulmonary disease overlapHamada K. Fayed0Yasen G. Abd-Elkareem1Wassem A. Samaha2Maher S. Abdalshakour3Department of Chest Diseases, Al Forsan Building, Al-Azhar Street, Al-Azhar University HospitalDepartment of Chest Diseases, Al Forsan Building, Al-Azhar Street, Al-Azhar University HospitalDepartment of Radiological, Al-Azhar University HospitalPhysiological Department, Al-Azhar UniversityAbstract Background Persons with asthma–chronic obstructive pulmonary disease (COPD) overlap (ACO) are a crucial but poorly characterized group. In spite of the numbers of patients with ACO have increased, there is minimal confirmed evidence regarding diagnostic features and choices of treatment. So, the aim of this study was to identify the physiological and radiological characteristics of patients with ACO. Patients and methods This study was performed on 200 patients classified into 38 patients diagnosed as having asthma, 132 patients diagnosed as having COPD, and 30 patients diagnosed as having ACO, who were chosen based on clinical features. All patients underwent pulmonary function tests, and multislice computed tomography imaging. Results The mean age of our study population was 61 years. The mean age in COPD group was higher compared with asthma and ACO groups (63.9±7.8 vs. 44.84±12.2 and 56.7 ±8, respectively), with a predominance of males in COPD and females in asthma, with a higher smoking index in patients with COPD than those with ACO and asthma (47.05±37.7, 13.53±2.2, and 2.47±1.46, respectively). Measurements of forced expiratory volume in 1 s (FEV1) by liters before bronchodilator therapy is greater in patients with asthma than ACO and COPD groups (1.89±0.42, 1.52±0.39, and 1.35 ±0.4, respectively), with highly significant difference (P<0.001). With airway reversibility, it is also greater in patients with asthma than ACO and COPD groups (2.85 ±0.49, 1.99±0.47, and 1.41±0.39, respectively), with a highly significant difference (P<0.001). Airway internal diameter of patients with COPD is greater than ACO and asthma groups (4.03±0.3, 3.92±0.17, and 2.82±0.31, respectively), with a highly significant difference (P<0.001). On the contrary, airway external diameter of patients with COPD is greater than asthma and ACO groups, with a highly significant difference (P<0.001). Airway wall thickness of patients with asthma is greater than ACO and COPD groups, with a highly statistical difference (P<0.001). There is no relation between thickness of airway wall and airway obstruction, expressed as FEV1 %predicted, in patients with asthma and COPD. This study results confirmed the correlation between the thickness of airway wall and airway obstruction, expressed as FEV1 % predicted, in patients with ACO. Conclusion Bronchial wall thickness measured by chest high resolution computed tomography (HRCT) is increased in patients with asthma than those with ACO and COPD, with a high statistical significance.https://doi.org/10.4103/ejb.ejb_14_19asthma–chronic obstructive pulmonary disease overlapasthmachronic obstructive pulmonary disease
spellingShingle Hamada K. Fayed
Yasen G. Abd-Elkareem
Wassem A. Samaha
Maher S. Abdalshakour
Functional and radiological characteristics of asthma combined chronic obstructive pulmonary disease overlap
The Egyptian Journal of Bronchology
asthma–chronic obstructive pulmonary disease overlap
asthma
chronic obstructive pulmonary disease
title Functional and radiological characteristics of asthma combined chronic obstructive pulmonary disease overlap
title_full Functional and radiological characteristics of asthma combined chronic obstructive pulmonary disease overlap
title_fullStr Functional and radiological characteristics of asthma combined chronic obstructive pulmonary disease overlap
title_full_unstemmed Functional and radiological characteristics of asthma combined chronic obstructive pulmonary disease overlap
title_short Functional and radiological characteristics of asthma combined chronic obstructive pulmonary disease overlap
title_sort functional and radiological characteristics of asthma combined chronic obstructive pulmonary disease overlap
topic asthma–chronic obstructive pulmonary disease overlap
asthma
chronic obstructive pulmonary disease
url https://doi.org/10.4103/ejb.ejb_14_19
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AT yasengabdelkareem functionalandradiologicalcharacteristicsofasthmacombinedchronicobstructivepulmonarydiseaseoverlap
AT wassemasamaha functionalandradiologicalcharacteristicsofasthmacombinedchronicobstructivepulmonarydiseaseoverlap
AT mahersabdalshakour functionalandradiologicalcharacteristicsofasthmacombinedchronicobstructivepulmonarydiseaseoverlap