Emphysema-Predominant COPD Had a Greater 5-Year Mortality and a Worse Annual Decline in Lung Function Than Airway Obstruction-Predominant COPD or Asthma at Initial Same Degree of Airflow Obstruction

<i>Background and Objectives:</i> We studied whether the extent of exertional oxygen desaturation and emphysema could cause greater mortality in COPD and asthma independent of airflow obstruction. <i>Materials and Methods:</i> We performed a 5-year longitudinal observational...

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Autores principales:	Chang-Wei Lin, Hung-Yu Huang, Fu-Tsai Chung, Chun-Yu Lo, Yu-Chen Huang, Ting-Wen Wang, Lan-Yan Yang, Yu-Bin Pan, Kian Fan Chung, Chun-Hua Wang
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	chronic obstructive pulmonary disease asthma emphysema 6 min walk test pulmonary function desaturation Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/bdb206d500cd4eb09cfe0e25ae87af32
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spelling	oai:doaj.org-article:bdb206d500cd4eb09cfe0e25ae87af322021-11-25T18:19:01ZEmphysema-Predominant COPD Had a Greater 5-Year Mortality and a Worse Annual Decline in Lung Function Than Airway Obstruction-Predominant COPD or Asthma at Initial Same Degree of Airflow Obstruction10.3390/medicina571112611648-91441010-660Xhttps://doaj.org/article/bdb206d500cd4eb09cfe0e25ae87af322021-11-01T00:00:00Zhttps://www.mdpi.com/1648-9144/57/11/1261https://doaj.org/toc/1010-660Xhttps://doaj.org/toc/1648-9144<i>Background and Objectives:</i> We studied whether the extent of exertional oxygen desaturation and emphysema could cause greater mortality in COPD and asthma independent of airflow obstruction. <i>Materials and Methods:</i> We performed a 5-year longitudinal observational study in COPD and asthma patients who matched for airflow obstruction severity. All subjects performed a 6-min walk test (6MWT) and high-resolution computed tomography (HRCT) and followed spirometry and oxygen saturation (SpO<sub>2</sub>) during the 6MWT every 3–6 months. Overall survival was recorded. Cumulative survival curves were performed according to the Kaplan–Meier method and compared with the log-rank test. <i>Results:</i> The COPD group had higher emphysema scores, higher Δinspiratory capacities (ICs) and lower SpO<sub>2</sub> during the 6MWT, which showed a greater yearly decline in FEV<sub>1</sub> (40.6 mL) and forced vital capacity (FVC) (28 mL) than the asthma group (FEV<sub>1</sub>, 9.6 mL; FVC, 1.2 mL; <i>p</i> < 0.05). The emphysema-predominant COPD group had an accelerated annual decline in lung function and worse survival. The nadir SpO<sub>2</sub> ≤ 80% and a higher emphysema score were the strong risk factors for mortality in COPD patients. <i>Conclusions:</i> The greater structural changes with a higher emphysema score and greater desaturation during the 6MWT in COPD may contribute to worse yearly decline in FEV<sub>1</sub> and higher five-year mortality than in asthma patients with a similar airflow obstruction. The lowest SpO<sub>2</sub> ≤ 80% during the 6MWT and emphysema-predominant COPD were the strong independent factors for mortality in chronic obstructive airway disease patients.Chang-Wei LinHung-Yu HuangFu-Tsai ChungChun-Yu LoYu-Chen HuangTing-Wen WangLan-Yan YangYu-Bin PanKian Fan ChungChun-Hua WangMDPI AGarticlechronic obstructive pulmonary diseaseasthmaemphysema6 min walk testpulmonary functiondesaturationMedicine (General)R5-920ENMedicina, Vol 57, Iss 1261, p 1261 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	chronic obstructive pulmonary disease asthma emphysema 6 min walk test pulmonary function desaturation Medicine (General) R5-920
spellingShingle	chronic obstructive pulmonary disease asthma emphysema 6 min walk test pulmonary function desaturation Medicine (General) R5-920 Chang-Wei Lin Hung-Yu Huang Fu-Tsai Chung Chun-Yu Lo Yu-Chen Huang Ting-Wen Wang Lan-Yan Yang Yu-Bin Pan Kian Fan Chung Chun-Hua Wang Emphysema-Predominant COPD Had a Greater 5-Year Mortality and a Worse Annual Decline in Lung Function Than Airway Obstruction-Predominant COPD or Asthma at Initial Same Degree of Airflow Obstruction
description	<i>Background and Objectives:</i> We studied whether the extent of exertional oxygen desaturation and emphysema could cause greater mortality in COPD and asthma independent of airflow obstruction. <i>Materials and Methods:</i> We performed a 5-year longitudinal observational study in COPD and asthma patients who matched for airflow obstruction severity. All subjects performed a 6-min walk test (6MWT) and high-resolution computed tomography (HRCT) and followed spirometry and oxygen saturation (SpO<sub>2</sub>) during the 6MWT every 3–6 months. Overall survival was recorded. Cumulative survival curves were performed according to the Kaplan–Meier method and compared with the log-rank test. <i>Results:</i> The COPD group had higher emphysema scores, higher Δinspiratory capacities (ICs) and lower SpO<sub>2</sub> during the 6MWT, which showed a greater yearly decline in FEV<sub>1</sub> (40.6 mL) and forced vital capacity (FVC) (28 mL) than the asthma group (FEV<sub>1</sub>, 9.6 mL; FVC, 1.2 mL; <i>p</i> < 0.05). The emphysema-predominant COPD group had an accelerated annual decline in lung function and worse survival. The nadir SpO<sub>2</sub> ≤ 80% and a higher emphysema score were the strong risk factors for mortality in COPD patients. <i>Conclusions:</i> The greater structural changes with a higher emphysema score and greater desaturation during the 6MWT in COPD may contribute to worse yearly decline in FEV<sub>1</sub> and higher five-year mortality than in asthma patients with a similar airflow obstruction. The lowest SpO<sub>2</sub> ≤ 80% during the 6MWT and emphysema-predominant COPD were the strong independent factors for mortality in chronic obstructive airway disease patients.
format	article
author	Chang-Wei Lin Hung-Yu Huang Fu-Tsai Chung Chun-Yu Lo Yu-Chen Huang Ting-Wen Wang Lan-Yan Yang Yu-Bin Pan Kian Fan Chung Chun-Hua Wang
author_facet	Chang-Wei Lin Hung-Yu Huang Fu-Tsai Chung Chun-Yu Lo Yu-Chen Huang Ting-Wen Wang Lan-Yan Yang Yu-Bin Pan Kian Fan Chung Chun-Hua Wang
author_sort	Chang-Wei Lin
title	Emphysema-Predominant COPD Had a Greater 5-Year Mortality and a Worse Annual Decline in Lung Function Than Airway Obstruction-Predominant COPD or Asthma at Initial Same Degree of Airflow Obstruction
title_short	Emphysema-Predominant COPD Had a Greater 5-Year Mortality and a Worse Annual Decline in Lung Function Than Airway Obstruction-Predominant COPD or Asthma at Initial Same Degree of Airflow Obstruction
title_full	Emphysema-Predominant COPD Had a Greater 5-Year Mortality and a Worse Annual Decline in Lung Function Than Airway Obstruction-Predominant COPD or Asthma at Initial Same Degree of Airflow Obstruction
title_fullStr	Emphysema-Predominant COPD Had a Greater 5-Year Mortality and a Worse Annual Decline in Lung Function Than Airway Obstruction-Predominant COPD or Asthma at Initial Same Degree of Airflow Obstruction
title_full_unstemmed	Emphysema-Predominant COPD Had a Greater 5-Year Mortality and a Worse Annual Decline in Lung Function Than Airway Obstruction-Predominant COPD or Asthma at Initial Same Degree of Airflow Obstruction
title_sort	emphysema-predominant copd had a greater 5-year mortality and a worse annual decline in lung function than airway obstruction-predominant copd or asthma at initial same degree of airflow obstruction
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/bdb206d500cd4eb09cfe0e25ae87af32
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Emphysema-Predominant COPD Had a Greater 5-Year Mortality and a Worse Annual Decline in Lung Function Than Airway Obstruction-Predominant COPD or Asthma at Initial Same Degree of Airflow Obstruction

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