title: Emphysema presence, severity, and distribution has little impact on the clinical presentation of a cohort of patients with mild to moderate COPD.
abstract: BACKGROUND
  Phenotypic characterization of patients with COPD may have potential prognostic and therapeutic implications. Available information on the relationship between emphysema and the clinical presentation in patients with COPD is limited to advanced stages of the disease. The objective of this study was to describe emphysema presence, severity, and distribution and its impact on clinical presentation of patients with mild to moderate COPD.
  
  
  METHODS
  One hundred fifteen patients with COPD underwent clinical and chest CT scan evaluation for the presence, severity, and distribution of emphysema. Patients with and without emphysema and with different forms of emphysema distribution (upper/lower/core/peel) were compared. The impact of emphysema severity and distribution on clinical presentation was determined.
  
  
  RESULTS
  Fifty percent of the patients had mild homogeneously distributed emphysema (1.84; 0.76%-4.77%). Upper and core zones had the more severe degree of emphysema. Patients with emphysema were older, more frequently men, and had lower FEV(1)%, higher total lung capacity percentage, and lower diffusing capacity of the lung for carbon monoxide. No differences were found between the clinical or physiologic parameters of the different emphysema distributions.
  
  
  CONCLUSIONS
  In patients with mild to moderate COPD, although the presence of emphysema has an impact on physiologic presentation, its severity and distribution seem to have little impact on clinical presentation.
authors: Department of Pulmonology, University Clinic of Navarra, Pamplona, Spain. jupa65@hotmail.com
authors: Juan P
authors: JP
authors: de Torres
authors: Gorka
authors: G
authors: Bastarrika
authors: Jorge
authors: J
authors: Zagaceta
authors: Ramón
authors: R
authors: Sáiz-Mendiguren
authors: Ana B
authors: AB
authors: Alcaide
authors: Luis M
authors: LM
authors: Seijo
authors: Usua
authors: U
authors: Montes
authors: Arantza
authors: A
authors: Campo
authors: Javier J
authors: JJ
authors: Zulueta
mesh_terms: D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D013147:Spirometry; D014057:Tomography, X-Ray Computed; D014109:Total Lung Capacity