Dynamic Expiratory Tracheal Collapse in Morbidly Obese COPD Patients

被引:40
作者
Boiselle, Phillip M. [1 ,2 ,3 ]
Litmanovich, Diana E. [1 ,2 ,3 ]
Michaud, Gaetane [4 ,5 ]
Roberts, David H. [3 ,6 ]
Loring, Stephen H. [7 ]
Womble, Hilary M. [3 ,6 ]
Millett, Mary E. [1 ,2 ,3 ]
O'Donnell, Carl R. [3 ,6 ]
机构
[1] Beth Israel Deaconess Med Ctr, Ctr Airway Imaging, Boston, MA 02215 USA
[2] Beth Israel Deaconess Med Ctr, Dept Radiol, Boston, MA 02215 USA
[3] Harvard Univ, Sch Med, Boston, MA USA
[4] Yale New Haven Med Ctr, New Haven, CT 06504 USA
[5] Yale Univ, Sch Med, New Haven, CT USA
[6] Beth Israel Deaconess Med Ctr, Dept Med, Div Pulm Crit Care & Sleep Med, Boston, MA 02215 USA
[7] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA
基金
美国国家卫生研究院;
关键词
CT; tracheomalacia; airways; phenotype; metabolic syndrome; CHRONIC-BRONCHITIS; METABOLIC SYNDROME; MULTIDETECTOR CT; AIRWAY COLLAPSE; TRACHEOBRONCHOMALACIA; STATEMENT;
D O I
10.3109/15412555.2013.781149
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Morbid obesity may influence several aspects of airway function. However, the effect of morbid obesity on expiratory tracheal collapse in COPD patients is unknown. We thus prospectively studied 100 COPD patients who underwent full pulmonary function tests (PFTs), 6-minute walk test (6MWT), Saint George's Respiratory Questionnaire (SGRQ), and low-dose CT at total lung capacity and during dynamic exhalation with spirometric monitoring. We examined correlations between percentage dynamic expiratory tracheal collapse and body mass index (BMI). The association between tracheal collapse and BMI was compared to a control group of 53 volunteers without COPD. Patients included 48 women and 52 men with mean age 65 +/- 7 years; BMI 30 +/- 6; FEV1 64 +/- 22 % predicted and percentage expiratory collapse 59 +/- 19%. Expiratory collapse was significantly associated with BMI (69 +/- 12% tracheal collapse among 20 morbidly obese patients with BMI >= 35 compared to 57 +/- 19% in others, p = 0.002, t-test). In contrast, there was no significant difference in collapse between healthy volunteers with BMI >= 35 and < 35. COPD patients with BMI >= 35 also demonstrated shorter 6MWT distances (340 +/- 139 m vs. 430 +/- 139 m, p = 0.003) and higher (worse) total SGRQ scores (48 +/- 19 vs. 36 +/- 20, p = 0.013) compared to those with BMI < 35. In light of these results, clinicians should consider evaluating for excessive expiratory tracheal collapse when confronted with a morbidly obese COPD patient with greater quality of life impairment and worse exercise performance than expected based on functional measures.
引用
收藏
页码:604 / 610
页数:7
相关论文
共 25 条
  • [11] Airway stabilization with silicone Stents for treating adult tracheobronchomalacia - A prospective observational study
    Ernst, Armin
    Majid, Adnan
    Feller-Kopman, David
    Guerrero, Jorge
    Boiselle, Phillip
    Loring, Stephen H.
    O'Donnell, Carl
    DeCamp, Malcolm
    Herth, Felix J. F.
    Gangadharan, Sidhu
    Ashiku, Simon
    [J]. CHEST, 2007, 132 (02) : 609 - 616
  • [12] Obesity and the lung: 5 . Obesity and COPD
    Franssen, F. M. E.
    O'Donnell, D. E.
    Goossens, G. H.
    Blaak, E. E.
    Schols, A. M. W. J.
    [J]. THORAX, 2008, 63 (12) : 1110 - 1117
  • [13] Original report - Tracheobronchomalacia: Dynamic airway evaluation with multidetector CT
    Gilkeson, RC
    Ciancibello, LM
    Hejal, RB
    Montenegro, HD
    Lange, P
    [J]. AMERICAN JOURNAL OF ROENTGENOLOGY, 2001, 176 (01) : 205 - 210
  • [14] The relation of body mass index to asthma, chronic bronchitis, and emphysema
    Guerra, S
    Sherrill, DL
    Bobadilla, A
    Martinez, FD
    Barbee, RA
    [J]. CHEST, 2002, 122 (04) : 1256 - 1263
  • [15] THE ST-GEORGE RESPIRATORY QUESTIONNAIRE
    JONES, PW
    QUIRK, FH
    BAVEYSTOCK, CM
    [J]. RESPIRATORY MEDICINE, 1991, 85 : 25 - 31
  • [16] Comparison of dynamic expiratory CT with bronchoscopy for diagnosing airway malacia - A pilot evaluation
    Lee, Karen S.
    Sun, Maryellen R. M.
    Ernst, Armin
    Feller-Kopman, David
    Majid, Adnan
    Boiselle, Phillip M.
    [J]. CHEST, 2007, 131 (03) : 758 - 764
  • [17] Tracheobronchoplasty for Severe Tracheobronchomalacia A Prospective Outcome Analysis
    Majid, Adnan
    Guerrero, Jorge
    Gangadharan, Sidhu
    Feller-Kopman, David
    Boiselle, Phillip
    DeCamp, Malcolm
    Ashiku, Simon
    Michaud, Gaetane
    Herth, Felix
    Ernst, Armin
    [J]. CHEST, 2008, 134 (04) : 801 - 807
  • [18] Marquis Karine, 2005, J Cardiopulm Rehabil, V25, P226, DOI 10.1097/00008483-200507000-00010
  • [19] General considerations for lung function testing
    Miller, MR
    Crapo, R
    Hankinson, J
    Brusasco, V
    Burgos, F
    Casaburi, R
    Coates, A
    Enright, P
    van der Grinten, CPM
    Gustafsson, P
    Jensen, R
    Johnson, DC
    MacIntyre, N
    McKay, R
    Navajas, D
    Pedersen, OF
    Pellegrino, R
    Viegi, G
    Wanger, J
    [J]. EUROPEAN RESPIRATORY JOURNAL, 2005, 26 (01) : 153 - 161
  • [20] Tracheobronchomalacia and excessive dynamic airway collapse
    Murgu, Septimiu D.
    Colt, Henri G.
    [J]. RESPIROLOGY, 2006, 11 (04) : 388 - 406