International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Correlation Between Diaphragmatic Excursion and Exercise Tolerance Improvement Following Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease-Obstructive Sleep Apnea Overlap Syndrome","authors":"Honghua Shen, Yiming Xu, Yin Zhang, Lei Ren, Rui Chen","doi":"10.2147/copd.s437698","DOIUrl":"https://doi.org/10.2147/copd.s437698","url":null,"abstract":"<strong>Purpose:</strong> We assess the predictive value of diaphragm excursion (DE) in enhancing exercise tolerance following pulmonary rehabilitation (PR) among patients with COPD-OSA overlap syndrome.<br/><strong>Material and Methods:</strong> This prospective cohort study enrolled 63 patients diagnosed with COPD-OSA overlap syndrome who actively participated in a PR program from January 2021 to May 2023. Among these, 58 patients successfully completed the 20-week PR program, with exercise tolerance assessed through the measurement of six-minute walk distance (6MWD), and DE evaluated by ultrasonography. The responder to PR in terms of exercise ability was defined as a patient who showed an increase of &gt; 30m in 6MWD. The cutoff value for predicting PR response based on DE was determined using receiver operating characteristic (ROC) curves.<br/><strong>Results:</strong> Following the PR program, significant improvements were observed in mMRC, 6MWD, DE during deep breathing, and diaphragm thickness fraction (DTF). Of the participants, 33 patients (57%) were classified as responders, while 25 patients (43%) were considered non-responders. Baseline values of FEV₁% predicted, 6MWD, DE during deep breathing, DTF, and PaO₂ exhibited a significant elevation in responders as compared to non-responders. The changes of 6MWD were positively associated with the baseline values of DTF and DE during deep breathing, FEV₁% predicted and PaO₂, while negatively correlated with baseline value of mMRC. The predictive performance in terms of the area under the ROC curve for determining responder’s DTF was found to be 0.769, accompanied by a sensitivity of 85% and specificity of 68%, using a cutoff value at 17.26%. Moreover, it was observed that DE during deep breathing could predict the area under the ROC curve for responders to be 0.753, with a sensitivity of 91% and specificity of 56% at a cutoff value of 3.61cm.<br/><strong>Conclusion:</strong> Diaphragm excursion serves as a valuable predictor for determining the enhancement of exercise tolerance following PR in patients with COPD-OSA overlap syndrome.<br/><strong>Trial Registration:</strong> ChiCTR1800020257, <u>www.chictr.org.cn/index.aspx</u>.<br/><br/><strong>Keywords:</strong> pulmonary rehabilitation, COPD-OSA overlap syndrome, diaphragm excursion, diaphragm thickness fraction, six-minute walk distance<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"9 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139412665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Assessment Characteristics of Small Pulmonary Vessel Remodelling in Populations at High Risk for COPD and Smokers Using Low-Dose CT","authors":"Yu Pu, Xiuxiu Zhou, Di Zhang, Yu Guan, Yi Xia, Shiyuan Liu, Li Fan","doi":"10.2147/copd.s436242","DOIUrl":"https://doi.org/10.2147/copd.s436242","url":null,"abstract":"<strong>Purpose:</strong> To explore the morphological alterations in small pulmonary vessels in populations at high risk for chronic obstructive pulmonary disease (COPD) and smokers based on multiple computed tomography (CT) quantitative parameters.<br/><strong>Patients and Methods:</strong> A total of 1969 Three Major Chest Diseases Screening Study participants with available demographic data and smoking history who underwent low-dose chest CT from 2018 to 2020 were included. All subjects were divided into normal, high risk for COPD, and COPD groups according to their pulmonary function test (PFT) results. Furthermore, the three groups were further subdivided into never-smokers, current smokers, and former smokers subgroups according to their smoking history. Quantitative parameters, such as the number, area at 6 mm~24 mm subpleura and volume of small pulmonary vessels, were extracted by computer software. Differences in small pulmonary vessel parameters among the groups were compared using two-way ANOVA.<br/><strong>Results:</strong> The number, area at 6 mm~24 mm subpleura and volume of small pulmonary vessels in the group at high risk for COPD were lower than those in the normal group (P&lt; 0.05). The number, area at 6 mm~24 mm subpleura and volume of small pulmonary vessels in the COPD group were higher than those in the normal group (P&lt; 0.05). The number, area of small pulmonary vessels at 6 mm~12 mm subpleura in current smokers with high risk for COPD were higher than those in former smokers with high risk for COPD (P&lt; 0.05).<br/><strong>Conclusion:</strong> The number, area, and volume of small pulmonary vessels in populations at high risk for COPD were decreased. Smoking cessation may impede structural changes in small pulmonary vessels in populations at high risk for COPD.<br/><br/><strong>Keywords:</strong> chronic obstructive pulmonary disease, computed tomography, pulmonary vascular structure, quantitative analysis, smoking<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"11 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139376685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abhd2, a Candidate Gene Regulating Airway Remodeling in COPD via TGF-β","authors":"Mei-Yu Lv, Ling-Ling Jin, Xi-Qiao Sang, Wen-Chao Shi, Li-Xia Qiang, Qing-Yan Lin, Shou-De Jin","doi":"10.2147/copd.s440200","DOIUrl":"https://doi.org/10.2147/copd.s440200","url":null,"abstract":"<strong>Purpose:</strong> The typical characteristic of COPD is airway remodeling, affected by environmental and genetic factors. However, genetic studies on COPD have been limited. Currently, the Abhd2 gene is found to play a critical role in maintaining alveolar architecture and stability. The research aims to investigate the predictive value of Abhd2 for airway remodeling in COPD and its effect on TGF-β regulation.<br/><strong>Methods:</strong> In humans, Abhd2 protein was obtained from peripheral blood monocytes. Peripheral blood TGF-β, pulmonary surfactant proteins (SPs), metalloproteinases, inflammatory indicators (WBC, NEU, NLR, EOS, CRP, PCT, D-Dimer), chest CT (airway diameter and airway wall thickness), pulmonary function, and blood gas analysis were used to assess airway remodeling. In animals, Abhd2 deficient mice (<em>Abhd2^Gt/Gt</em>) using gene trapping and C57BL6 mice were injected intraperitoneally with CSE to construct COPD models. HE staining, Masson staining and immunohistochemistry were used to observe the pathological changes of airway in mice, and RT-PCR, WB, ELISA and immunofluorescence were used to detect the expression of secreted proteins and EMT markers.<br/><strong>Results:</strong> COPD patients with worse pulmonary function and higher airway remodeling-related inflammatory factors had lower Abhd2 protein expression. Moreover, indicators followed the same trend for COPD patients grouped by prognosis (Group A vs Group B). Serum TGF-β was negatively correlated with Abhd2 protein expression, FEV1/FVC, FEV1, and FEV1% PRED. In mice, <em>Abhd2</em> depletion promoted deposition of TGF-β, leading to more pronounced emphysema, airway thickening, increased alveolar macrophage infiltration, decreased AECII number and SPs, and EMT phenomenon.<br/><strong>Conclusion:</strong> Downregulation of <em>Abhd2</em> can promote airway remodeling in COPD by modulating repair after injury and EMT via TGF-β. This study suggests that <em>Abhd2</em> may serve as a biomarker for assessing airway remodeling and guiding prognosis in COPD.<br/><br/><strong>Keywords:</strong> alpha/beta hydrolase 2, COPD, TGF-β, airway remodeling, EMT<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"117 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139104561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Role of White Blood Cell Differential Count for the Development of Acute Exacerbation in Korean Chronic Obstructive Pulmonary Disease","authors":"Eun Chong Yoon, So-My Koo, Hye Yun Park, Ho Cheol Kim, Woo Jin Kim, Ki Uk Kim, Ki-Suck Jung, Kwang Ha Yoo, Hyoung Kyu Yoon, Hee-Young Yoon","doi":"10.2147/copd.s435921","DOIUrl":"https://doi.org/10.2147/copd.s435921","url":null,"abstract":"<strong>Purpose:</strong> Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by chronic inflammation. Acute exacerbation of COPD (AECOPD) manifests as acute worsening of respiratory symptoms and is associated with high morbidity and mortality. The aim of the present study was to evaluate the predictive value of white blood count (WBC) and its derived inflammatory biomarkers for AECOPD.<br/><strong>Methods:</strong> From the Korean COPD Subgroup Study cohort, a prospective and multicenter observational study, 826 patients who had baseline complete blood count (CBC) and 3-year AECOPD data were included. Follow-up CBC data at 1 (n = 385), 2 (n = 294), and 3 (n = 231) years were collected for available patients. The primary outcome was the occurrence of AECOPD at 3 years. The risk of AECOPD was evaluated using a binary logistic analysis.<br/><strong>Results:</strong> The cumulative incidences of 12-, 24-, and 36-month AECOPD were 47.6%, 60.5%, and 67.6%, respectively. Patients with AECOPD at 3 years had higher baseline WBC counts, neutrophil counts, neutrophil/lymphocyte ratio (NLR), and neutrophil/monocyte ratio than those without AECOPD. Higher WBC count, neutrophil count, and NLR were associated with the 3-year occurrence of AECOPD in the univariate analysis, but only the higher neutrophil count was a significant risk factor (odds ratio [OR] = 1.468; 95% confidence interval [CI]: 1.024– 2.104) in the covariates-adjusted analysis. In the analysis of changes in inflammatory parameters, a decrease in the platelet count (OR = 0.502; 95% CI: 0.280– 0.902) and NLR (OR = 0.535; 95% CI: 0.294– 0.974) at 2 years and an increase in the eosinophil count (OR = 2.130; 95% CI: 1.027– 4.416) at 3 years were significantly associated with AECOPD in the adjusted analysis.<br/><strong>Conclusion:</strong> Our data suggest that a high baseline WBC count, particularly neutrophil count, was associated with a higher incidence of long-term AECOPD.<br/><br/><strong>Keywords:</strong> blood cell count, blood platelets, eosinophils, lymphocytes, neutrophils, pulmonary disease, chronic obstructive<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"9 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139096424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives on Ensifentrine and Its Therapeutic Potential in the Treatment of COPD: Evidence to Date","authors":"Muhammad Asad Faruqi, Malik M Khurram S Khan, David M Mannino","doi":"10.2147/copd.s385811","DOIUrl":"https://doi.org/10.2147/copd.s385811","url":null,"abstract":"<strong>Abstract:</strong> Ensifentrine is a novel inhalational phosphodiesterase (PDE)3 and PDE4 inhibitor which improves bronchodilation and decreases inflammatory markers by acting locally on the bronchial tissue, with minimal systemic effects. Both preclinical and clinical trials have demonstrated benefits of this therapy, including improvement in lung function and reduction in exacerbations. This therapy is currently under review by the US Food and Drug Administration with a decision expected in 2024.<br/><br/><strong>Keywords:</strong> chronic obstructive pulmonary disease, therapy, phosphodiesterase inhibitor<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"1 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139082731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sputum Biomarkers in Wood and Tobacco Smoke Etiotypes of Chronic Obstructive Pulmonary Disease","authors":"Ángela María Giraldo-Montoya, Carlos A Torres-Duque, Luis F Giraldo-Cadavid, Maria E Laucho-Contreras, Angélica González-Flórez, Ana María Santos, Eduardo A Tuta-Quintero, Bartolomé R Celli, Mauricio González-García","doi":"10.2147/copd.s439064","DOIUrl":"https://doi.org/10.2147/copd.s439064","url":null,"abstract":"<strong>Introduction:</strong> There is a need to better understand the etiotypes of chronic obstructive pulmonary disease (COPD) beyond the tobacco-smoke (TS-COPD). Wood smoke COPD (WS-COPD) is characterized by greater airway compromise, milder emphysema, and slower rate of lung function decline than TS-COPD. However, it is unclear if these two etiotypes of COPD have differences in sputum biomarker concentrations. Objective was to compare sputum levels of selected sputum biomarkers between WS-COPD and TS-COPD, and healthy controls.<br/><strong>Methods:</strong> Eighty-eight women (69± 12 years) were recruited and classified into: WS-COPD (n=31), TS-COPD (n=29) and controls (n=28). Using ELISA, we determined induced sputum levels of metalloproteinase 9 (MMP-9), chemokine ligand 5 (CCL5), interleukin-8 (IL-8), chemokine ligand 16 (CCL16/HCC-4) and vascular endothelial growth factor (VEGF-1). Differences were analyzed by Kruskal–Wallis and Mann–Whitney-<em>U</em> tests and correlation between airflow limitation and biomarkers by Spearman’s test.<br/><strong>Results:</strong> At similar degree of airflow obstruction, anthropometrics and medications use, the level of sputum CCL5 was higher in TS-COPD than WS-COPD (p=0.03) without differences in MMP-9, IL-8, CCL16/HCC-4, and VEGF-1. Women with WS-COPD and TS-COPD showed significantly higher sputum levels of MMP-9, IL-8 and CCL5 compared with controls (p&lt; 0.001). FEV₁% predicted correlated negatively with levels of MMP-9 (rho:-0.26; P=0.016), CCL5 (rho:-0.37; P=0.001), IL-8 (rho:-0.42; P&lt; 0.001) and VEGF (rho:-0.22; P=0.04).<br/><strong>Conclusion:</strong> While sputum concentrations of MMP-9, IL-8, and CCL5 were higher in COPD women compared with controls, women with TS-COPD had higher levels of CCL5 compared with those with WS-COPD. Whether this finding relates to differences in pathobiological pathways remains to be determined.<br/><br/><strong>Keywords:</strong> COPD, wood smoke, biomass fuels, tobacco smoke, biomarkers, sputum, cytokines<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"178 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139071697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual Ordinal Coronary Artery Calcium Score from Non-Gated Chest CT Predicts Mortality After Severe Chronic Obstructive Pulmonary Disease Exacerbation","authors":"Huiying Xu, Min Sen Yew","doi":"10.2147/copd.s437401","DOIUrl":"https://doi.org/10.2147/copd.s437401","url":null,"abstract":"<strong>Purpose:</strong> Chronic obstructive pulmonary disease (COPD) patients often undergo chest CT for various indications. Coronary artery calcium (CAC) can be quantified visually on ungated chest CT using an ordinal score that has been shown to correlate well with traditional Agatston CAC scoring. The prognostic role of CAC was studied mainly in stable COPD patients. We aim to study the association between ordinal CAC and mortality amongst patients admitted for acute exacerbation of COPD (AECOPD).<br/><strong>Patients and Methods:</strong> Retrospective study of AECOPD cases with no previous coronary revascularization admitted between 1st January 2016 to 30th June 2017 with a chest CT performed during admission or within 365 days prior. Ordinal CAC scoring (scale of 0– 12) was performed by an experienced CT cardiologist blinded to patient data and outcomes. Patient demographics and future clinical events were retrieved from electronic medical records.<br/><strong>Results:</strong> There were 93 patients included (87.1% male, mean age 75 years) with the majority (59.1%) in GOLD Stage III. There were 21 (22.6%) patients with no CAC as well as 39 (41.9%) and 33 (35.5%) with ordinal CAC of 1– 3 and 4– 12, respectively. There were no significant differences in Charlson Comorbidity Index (CCI) and the proportion of patients with traditional cardiovascular risk factors (namely hypertension, dyslipidaemia, diabetes and smoking status) between the ordinal CAC score groups. Over a median follow-up period of 2.9 (1.1– 3.9) years, there were 51 (54.8%) deaths. An ordinal CAC score of 4– 12 was the only significant predictor of mortality after multivariate Cox-regression analysis adjustment for age, gender, body mass index, prior exacerbations, FEV1, cardiovascular risk factors and CCI [HR 3.944, (95% confidence interval 1.647– 9.433, p = 0.002)].<br/><strong>Conclusion:</strong> Ordinal CAC measured from a current or recent ungated chest CT is an independent predictor of all-cause mortality in admitted AECOPD patients with no previous coronary revascularization.<br/><br/><strong>Keywords:</strong> chronic obstructive pulmonary disease, exacerbation, coronary artery calcium, mortality<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"80 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139053202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Genes Related to Endoplasmic Reticulum Stress (ERS) in Chronic Obstructive Pulmonary Disease (COPD) and Clinical Validation","authors":"Siming Tao, Jing Jing, Yide Wang, Fengsen Li, Hongxia Ma","doi":"10.2147/copd.s440692","DOIUrl":"https://doi.org/10.2147/copd.s440692","url":null,"abstract":"<strong>Objective:</strong> Endoplasmic reticulum stress (ERS) is key in chronic obstructive pulmonary disease (COPD) incidence and progression. This study aims to identify potential ERS-related genes in COPD through bioinformatics analysis and clinical experiments.<br/><strong>Methods:</strong> We first obtained a COPD-related mRNA expression dataset (GSE38974) from the Gene Expression Omnibus (GEO) database. The R software was then used to identify potential differentially expressed genes (DEGs) of COPD-related ERS (COPDERS). Subsequently, the identified DEGs were subjected to protein-protein interaction (PPI), correlation, Gene Ontology (GO) enrichment, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. Following that, qRT-PCR was used to examine the RNA expression of six ERS-related DEGs in blood samples obtained from the COPD and control groups. The genes were also subjected to microRNA analysis. Finally, a correlation analysis was performed between the DEGs and key clinical indicators.<br/><strong>Results:</strong> Six ERS-related DEGs (five upregulated and one downregulated) were identified based on samples drawn from 23 COPD patients and nine healthy individuals enrolled in the study. Enrichment analysis revealed multiple ERS-related pathways. The qRT-PCR and mRNA microarray bioinformatics analysis results showed consistent STC2, APAF1, BAX, and PTPN1 expressions in the COPD and control groups. Additionally, hsa-miR-485-5p was identified through microRNA prediction and DEG analysis. A correlation analysis between key genes and clinical indicators in COPD patients demonstrated that STC2 was positively and negatively correlated with eosinophil count (EOS) and lymphocyte count (LYM), respectively. On the other hand, PTPN1 showed a strong correlation with pulmonary function indicators.<br/><strong>Conclusion:</strong> Four COPDERS-related key genes (STC2, APAF1, BAX, and PTPN1) were identified through bioinformatics analysis and clinical validation, and the expressions of some genes exhibited a significant correlation with the selected clinical indicators. Furthermore, hsa-miR-485-5p was identified as a potential key target in COPDERS, but its precise mechanism remains unclear.<br/><br/><strong>Keywords:</strong> endoplasmic reticulum stress, chronic obstructive pulmonary disease, bioinformatics analysis, clinical prediction<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"36 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139053200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Diagnosis of High-Risk Chronic Obstructive Pulmonary Disease Based on Quantitative High-Resolution Computed Tomography Measurements","authors":"Wenxiu Zhang, Yu Zhao, Yuchi Tian, Xiaoyun Liang, Chenghao Piao","doi":"10.2147/copd.s436803","DOIUrl":"https://doi.org/10.2147/copd.s436803","url":null,"abstract":"<strong>Purpose:</strong> Quantitative computed tomography (QCT) techniques, focusing on airway anatomy and emphysema, may help to detect early structural changes of COPD disease. This retrospective study aims to identify high-risk COPD participants by using QCT measurements.<br/><strong>Patients and Methods:</strong> We enrolled 140 participants from the Second Affiliated Hospital of Shenyang Medical College who completed inspiratory high-resolution CT scans, pulmonary function tests (PFTs), and clinical characteristics recorded. They were diagnosed Non-COPD by PFT value of FEV1/FVC &gt; 70% and divided into two groups according percentage predicted FEV1 (FEV1%), low-risk COPD group: FEV1% ≥ 95%, high-risk group: 80% &lt; FEV1% &lt; 95%. The QCT measurements were analyzed by the Student’s <em>t</em>-test (or Mann–Whitney <em>U</em>-test) method. Then, feature candidates were identified using the LASSO method. Meanwhile, the correlation between QCT measurements and PFTs was assessed by the Spearman rank correlation test. Furthermore, support vector machine (SVM) was performed to identify high-risk COPD participants. The performance of the models was evaluated in terms of accuracy (ACC), sensitivity (SEN), specificity (SPE), F1-score, and area under the ROC curve (AUC), with p &lt; 0.05 considered statistically significant.<br/><strong>Results:</strong> The SVM based on QCT measurements achieved good performance in identifying high-risk COPD patients with 85.71% of ACC, 88.34% of SEN, 84.00% of SPE, 83.33% of F1-score, and 0.93 of AUC. Further, QCT measurements integration of clinical data improved the performance with an ACC of 90.48%. The emphysema index (%LAA_{− 950}) of left lower lung was negatively correlated with PFTs (P &lt; 0.001). The airway anatomy indexes of lumen diameter (LD) were correlated with PFTs.<br/><strong>Conclusion:</strong> QCT measurements combined with clinical information could provide an effective tool for an early diagnosis of high-risk COPD. The QCT indexes can be used to assess the pulmonary function status of high-risk COPD.<br/><br/><strong>Keywords:</strong> early diagnosis, QCT measurements, COPD, SVM<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139053591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Bisoprolol in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis","authors":"Zhouzhou Feng, Lu Zhang, Yaqin Wang, Hong Guo, Jian Liu","doi":"10.2147/copd.s438930","DOIUrl":"https://doi.org/10.2147/copd.s438930","url":null,"abstract":"<strong>Purpose:</strong> To evaluate the clinical efficacy and safety of bisoprolol in patients with chronic obstructive pulmonary disease (COPD).<br/><strong>Research Methods:</strong> This systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) statements. The primary outcome measures analyzed included: Pulmonary function(FEV1, FEV1%, FVC), 6-minute walking distance (6MWD), adverse events and inflammatory cytokines(IL-6, IL-8, CRP).<br/><strong>Results:</strong> Thirty-five studies were included with a total of 3269 study participants, including 1650 in the bisoprolol group and 1619 in the control group. The effect of bisoprolol on lung function in patients with COPD, FEV₁, MD (0.46 [95% CI, 0.27 to 0.65], P=0.000), FEV₁%, MD (− 0.64 [95% CI, 0.42 to 0.86], P=0.000), FVC, MD (0.20 [95% CI, 0.05 to 0.34], P=0.008), the results all showed a statistically significant result. The effect of bisoprolol on 6MWD in COPD patients, MD (1.37 [95% CI, 1.08 to 1.66], P=0.000), which showed a statistically significant result. The occurrence of adverse events in COPD patients treated with bisoprolol, RR (0.83 [95% CI, 0.54 to 1.26], P=0.382), resulted in no statistical significance. The effect of bisoprolol on inflammatory cytokines in COPD patients, IL-6, MD (− 1.16 [95% CI, − 1.67 to − 0.65], P=0.000), IL-8, MD (− 0.94 [95% CI, − 1.32 to − 0.56], P=0.000), CRP, MD (− 1.74 [95% CI, − 2.40 to − 1.09], P=0.000), the results were statistically significant. We performed a subgroup analysis of each outcome indicator according to whether the patients had heart failure or not, and the results showed that the therapeutic effect of bisoprolol on COPD did not change with the presence or absence of heart failure.<br/><strong>Conclusion:</strong> Bisoprolol is safe and effective in the treatment of COPD, improving lung function and exercise performance in patients with COPD, and also reducing inflammatory markers in patients with COPD, and this effect is independent of the presence or absence of heart failure.<br/><br/><strong>Keywords:</strong> chronic obstructive pulmonary disease, bisoprolol, beta-blockers, meta-analysis<br/>","PeriodicalId":13792,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"171 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139023870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}