title: Use of cluster analysis to describe desaturator phenotypes in COPD: correlations between pulmonary function tests and nocturnal oxygen desaturation.
abstract: BACKGROUND
  Significant heterogeneity of clinical presentation and disease progression exists within chronic obstructive pulmonary disease (COPD). Although forced expiratory volume in 1 second (FEV(1)) inadequately describes this heterogeneity, a clear alternative has not emerged. This article discusses and refines the concept of phenotyping desaturators in COPD and shows a possible pattern which could be used as a framework for future research.
  
  
  RESULTS
  COPD is a complex condition with pulmonary and extrapulmonary manifestations. We suggest that COPD phenotypes should be associated with clinically meaningful outcomes. The innovation of COPD phenotyping is defined as COPD desaturators. Sleep-related hypoxemia and hypercapnia are well recognized in COPD and the development of systemic inflammation during sleep. These sleep-related changes predispose to nocturnal cardiac arrhythmias, pulmonary hypertension, and possibly death, particularly during acute exacerbations.
  
  
  CONCLUSIONS
  A more focused definition makes possible a classification of patients into two distinct subgroups for both clinical and research purposes. Establishing a common language for future research will facilitate our understanding and management of such diseases. Even if different treatment strategies have different outcomes for these groups, we will have confirmation, or otherwise, of the clinical value of cluster analysis. This knowledge could lead to pharmacological treatment and other interventions directed to specific phenotypic groups.
authors.affiliation: A Galateo Lung Disease Hospital, Regional Service Puglia, San Cesario di Lecce, Italy. d.torald@tin.it
authors.forename: Domenico Maurizio
authors.initials: DM
authors.lastname: Toraldo
authors.forename: Francesco
authors.initials: F
authors.lastname: De Nuccio
authors.forename: Annarita
authors.initials: A
authors.lastname: Gaballo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nicolardi
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002940:Circadian Rhythm; D016000:Cluster Analysis; D003627:Data Interpretation, Statistical; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D000860:Hypoxia / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D007249:Inflammation / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D010641:Phenotype; D011237:Predictive Value of Tests; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000145:classification / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D012129:Respiratory Function Tests; D012890:Sleep; D012891:Sleep Apnea Syndromes / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D010100:Oxygen