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Free Content Different therapeutic responses in chronic obstructive pulmonary disease subgroups

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Abstract:

SETTING: Eleven referring hospitals in South Korea.

OBJECTIVE: To compare therapeutic responses in chronic obstructive pulmonary disease (COPD) subgroups, classified by diffusing capacity of the lung for carbon monoxide (DLCO) and lung volume.

DESIGN: A total of 130 stable male COPD patients were classified into four subgroups according to baseline DLCO and residual volume/total lung capacity (RV/TLC) ratio. We compared therapeutic responses to short acting β2-agonist (SABA) and 3-month combined inhalation of long-acting β2-agonist (LABA) and corticosteroid among patients with these subgroups.

RESULTS: Among the 130 COPD patients, 41 (31.5%) had normal DLCO and RV/TLC, 28 (21.5%) low DLCO and normal RV/TLC, 31 (23.8%) normal DLCO and high RV/TLC, and 30 (23.1%) low DLCO and high RV/TLC. The normal DLCO/high RV/TLC subgroup showed a significantly larger flow response (changes in forced expiratory volume in 1 s) to salbutamol than the normal DLCO/RV/TLC subgroups, and a larger volume response (changes in forced vital capacity) than the two normal RV/TLC subgroups. The normal DLCO/high RV/TLC subgroup also showed significantly larger flow and volume response to 3-month combined inhalation of LABA and corticosteroid than the two normal RV/TLC subgroups.

CONCLUSION: COPD subgroups classified by DLCO and RV/TLC may have different pulmonary function responses to pharmacological treatment.

Keywords: COPD; diffusing capacity; emphysema; lung volume

Document Type: Regular Paper

DOI: http://dx.doi.org/10.5588/ijtld.10.0553

Affiliations: 1: Department of Pulmonary and Critical Care Medicine, Asthma Center and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea 2: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea 3: Department of Pulmonary and Critical Care Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea 4: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Bundang Cha Hospital, Cha University, Seongnam, South Korea 5: Department of Radiology, East-West Neo Medical Center, Kyunghee University, Seoul, South Korea 6: Division of Pulmonology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea 7: Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, South Korea 8: Department of Internal Medicine, College of Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University, Seoul, South Korea 9: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; and Clinical Research Institute, Seoul National University Hospital, Lung Institute, Medical Research Center, Seoul, South Korea 10: Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Korea University Anam Hospital, Seoul, South Korea 11: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea 12: Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea 13: Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea 14: Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, South Korea

Publication date: August 1, 2011

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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