Influence of baseline airway calibre and pulmonary emphysema on bronchial responsiveness in patients with chronic obstructive pulmonary disease.
OBJECTIVE
Bronchial hyper-responsiveness (BHR) is widely observed in patients with chronic obstructive pulmonary disease (COPD). However, its clinical significance in COPD has not yet been established. To determine the factors that influence BHR in COPD, multiple linear regression analysis was used to analyse the relationship between BHR to methacholine and baseline forced expiratory volume in 1 s (FEV1), vital capacity (VC), residual volume (RV)/total lung capacity (TLC), static compliance (Cst), transfer coefficient of the lung (Kco), and the percentage of low attenuation area (%LAA) determined by computed tomographic (CT) scan.


METHODS
Bronchial responsiveness to methacholine was determined in 63 patients with COPD by the dosimeter method and expressed as PD20FEV1. Residual volume and TLC were determined by body plethysmography. The percentage of low attenuation area was defined as the percentage of area less than -960 Hounsfield unit on a CT scan of the thorax.


RESULTS
Forced expiratory volume in 1s (%predicted) and %LAA correlated with BHR (P = 0.023 and 0.020, respectively), while VC (%pred), RV/TLC, Cst and Kco did not. The coefficient of determination was 0.43. The regression analysis showed that a 10% increase in FEV1 (%pred) and a 10% decrease in %LAA would increase log(PD20FEV1) by 0.145 and 0.117, respectively.


CONCLUSIONS
A considerable proportion of the BHR in COPD is related to functional abnormalities and morphologic changes of emphysema, such as decreased baseline airway calibre and destruction of the lung parenchyma.
Koyama
H
H
Chest Disease Research Institute, Kyoto University, Japan.
Nishimura
K
K
Ikeda
A
A
Sakai
N
N
Mishima
M
M
Izumi
T
T
D000368:Aged; D001980:Bronchi / Q000187:drug effects / Q000503:physiopathology; D016535:Bronchial Hyperreactivity / Q000150:complications / Q000503:physiopathology*; D016085:Bronchoconstrictor Agents; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000150:complications / Q000503:physiopathology*; D016210:Methacholine Chloride; D011656:Pulmonary Emphysema / Q000150:complications / Q000503:physiopathology*; D012044:Regression Analysis; D012129:Respiratory Function Tests
D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride