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Longitudinal Lung Volume Changes in Patients with Chronic Obstructive Pulmonary Disease

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Abstract

Background

The progression of lung hyperinflation in patients with chronic obstructive pulmonary disease (COPD) has not been studied in a long-term prospective cohort. We explored the longitudinal changes in lung volume compartments with the aim of identifying predictors of a rapid decline of the inspiratory capacity to total lung capacity ratio (IC/TLC).

Methods

The study population comprised 324 patients with COPD who were recruited prospectively. Annual rates of changes in pulmonary function, including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), total lung capacity (TLC), functional residual capacity (FRC), residual volume (RV), vital capacity (VC), IC, and IC/TLC, were estimated using the random coefficient models.

Results

The mean annual rates of changes in pre- and post-bronchodilator FEV1 were −23.0 mL/year (p < 0.001) and −26.5 mL/year (p = 0.004). The mean annual rates of changes in VC, IC, TLC, and IC/TLC were −33.7 mL/year (p = 0.007), −53.9 mL/year (p < 0.001), −43.7 mL/year (p = 0.012), and −0.65 %/year (p = 0.001), respectively. RV, FRC, and RV/TLC did not change significantly during the study period. Multivariate logistic regression analysis showed that a high modified Medical Research Council (MMRC) dyspnea scale score, a high Charlson comorbidity index value, and low post-bronchodilator FEV1 were associated with rapid decline in IC/TLC.

Conclusion

MMRC dyspnea scale, post-bronchodilator FEV1, and the Charlson comorbidity index at baseline were independent predictors of a rapid decline in IC/TLC.

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Acknowledgments

This study was supported by Grants from the Korea Healthcare Technology R&D Project, Ministry for Health and Welfare Affairs, Republic of Korea (A102065).

Conflict of interest

Y. M. Oh has been an investigator in university-sponsored studies (Asan Institute for Life Science, University of Ulsan College of Medicine) and an industry-sponsored study (MSD Korea and AstraZeneca Korea) and has participated as a speaker at scientific meetings organized and financed by various pharmaceutical companies (Handok, GlaxoSmithKline, AstraZeneca Korea, MSD Korea, and Boehringer Ingelheim) and a magazine company (Korea Doctors’ Weekly). S. D. Lee serves as a consultant to GlaxoSmithKline and has participated as a speaker at scientific meetings organized and financed by various pharmaceutical companies (GlaxoSmithKline, AstraZeneca Korea, and Boehringer Ingelheim). J. S. Lee, S. O. Kim, K. H. Yoo, J. H. Lee, E. K. Kim, Y. K. Lee, T. H. Kim, W. J. Kim, J. H. Lee, S. M. Lee, S. Y. Lee, S. Y. Lim, T. R. Shin, H. I. Yoon, C. K. Rhee, S. W. Lee, and J. W. Huh have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Pulmonary and Critical Care Medicine, and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Olympic-ro 43 gil, Sonpa-gu, Seoul, 138-736, South Korea

    Jae Seung Lee, Sei Won Lee, Jin Won Huh, Yeon-Mok Oh & Sang-Do Lee

  2. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Seon Ok Kim

  3. Department of Internal Medicine, Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Joon Beom Seo

  4. Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, South Korea

    Ji-Hyun Lee & Eun Kyung Kim

  5. Division of Pulmonology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea

    Tae-Hyung Kim

  6. Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, South Korea

    Woo Jin Kim

  7. Department of Internal Medicine, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, South Korea

    Jin Hwa Lee

  8. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea

    Sang-Min Lee

  9. Clinical Research Institute, Seoul National University Hospital, Seoul, South Korea

    Sang-Min Lee

  10. Lung Institute, Medical Research Center, Seoul National University College of Medicine, Seoul, South Korea

    Sang-Min Lee

  11. Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Korea University Anam Hospital, Seoul, South Korea

    Sangyeub Lee

  12. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Seong Yong Lim

  13. Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea

    Tae Rim Shin

  14. Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea

    Ho Il Yoon

Authors
  1. Jae Seung Lee
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  2. Seon Ok Kim
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  7. Woo Jin Kim
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  8. Jin Hwa Lee
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  9. Sang-Min Lee
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  10. Sangyeub Lee
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  13. Ho Il Yoon
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  14. Sei Won Lee
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  15. Jin Won Huh
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  16. Yeon-Mok Oh
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  17. Sang-Do Lee
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Corresponding author

Correspondence to Yeon-Mok Oh.

Additional information

S.-D. Lee and Y.-M. Oh contributed equally to this study.

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Lee, J.S., Kim, S.O., Seo, J.B. et al. Longitudinal Lung Volume Changes in Patients with Chronic Obstructive Pulmonary Disease. Lung 191, 405–412 (2013). https://doi.org/10.1007/s00408-013-9478-0

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  • DOI: https://doi.org/10.1007/s00408-013-9478-0

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