바로가기메뉴

본문 바로가기 주메뉴 바로가기

Tuberculosis & Respiratory Diseases

Article Contents

Prev Next
e-Submission

Vol.72 No.4
Citation Share

Clinical Features according to the Frequency of Acute Exacerbation in COPD

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2012, v.72 no.4, pp.367-373
https://doi.org/10.4046/trd.2012.72.4.367











& (2012). Clinical Features according to the Frequency of Acute Exacerbation in COPD. Tuberculosis & Respiratory Diseases, 72(4), 367-373, https://doi.org/10.4046/trd.2012.72.4.367
  • Downloaded
  • Viewed
PDF Download

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is now regarded as a heterogenous disease, with variable phenotypes. Acute exacerbation of COPD is a major event that alters the natural course of disease. The frequency of COPD exacerbation is variable among patients. We analyzed clinical features, according to the frequency of acute exacerbation in COPD. Methods: Sixty patients, who visited Gyeongsang National University Hospital from March 2010 to October 2010,were enrolled. Patients were divided into two groups, according to their frequency of acute exacerbation. Frequent exacerbator is defined as the patient who has two or more exacerbation per one year. We reviewed patients’medical records and investigated modified Medical Research Council (MMRC) dyspnea scale, smoking history and frequency of acute exacerbation. We also conducted pulmonary function test and 6-minute walking test, calculated body mass index, degree of airway obstruction and dyspnea and exercise capacity (BODE) index and measured CD146 cells in the peripheral blood. Results: The number of frequent exacerbators and infrequent exacerbators was 20 and 40, respectively. The frequent exacerbator group had more severe airway obstruction (forced expiratory volume in one second [FEV1], 45% vs. 65.3%, p=0.001; FEV1/forced vital capacity, 44.3% vs. 50.5%, p=0.046). MMRC dyspnea scale and BODE index were significantly higher in the frequent exacerbator group (1.8 vs. 1.1, p=0.016; 3.9 vs. 2.1, p=0.014, respectively). The fraction of CD146 cells significantly increased in the frequent exacerbator group (2.0 vs. 1.0, p＜0.001). Conclusion: Frequent exacerbator had more severe airway obstruction and higher symptom score and BODE index. However, circulating endothelial cells measured by CD146 needed to be confirmed in the future.

keywords
Pulmonary Disease, Chronic Obstructive, Phenotype, Endothelial Cells

Reference

1.

1. Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2007;176:532-55.

2.

2. Friedlander AL, Lynch D, Dyar LA, Bowler RP. Phenotypes of chronic obstructive pulmonary disease. COPD 2007;4:355-84.

3.

3. Ståhl E, Lindberg A, Jansson SA, Rönmark E, Svensson K, Andersson F, et al. Health-related quality of life is related to COPD disease severity. Health Qual Life Outcomes 2005;3:56.

4.

4. Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 2004;350:1005-12.

5.

5. Ong KC, Earnest A, Lu SJ. A multidimensional grading system (BODE index) as predictor of hospitalization for COPD. Chest 2005;128:3810-6.

6.

6. Soler-Cataluña JJ, Rodriguez-Roisin R. Frequent chronic obstructive pulmonary disease exacerbators: how much real, how much fictitious? COPD 2010;7:276-84.

7.

7. Huertas A, Palange P. Circulating endothelial progenitor cells and chronic pulmonary diseases. Eur Respir J 2011;37:426-31.

8.

8. Sala E, Villena C, Balaguer C, Ríos A, Fernández- Palomeque C, Cosío BG, et al. Abnormal levels of circulating endothelial progenitor cells during exacerbations of COPD. Lung 2010;188:331-8.

9.

9. Hurst JR, Vestbo J, Anzueto A, Locantore N, Müllerova H, Tal-Singer R, et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med 2010;363:1128-38.

10.

10. Miravitlles M, Ferrer M, Pont A, Zalacain R, Alvarez-Sala JL, Masa F, et al. Effect of exacerbations on quality of life in patients with chronic obstructive pulmonary disease: a 2 year follow up study. Thorax 2004;59:387-95.

11.

11. Cote CG, Dordelly LJ, Celli BR. Impact of COPD exacerbations on patient-centered outcomes. Chest 2007; 131:696-704.

12.

12. Hodgev VA, Kostianev SS, Marinov BA. Correlation of frequency of exacerbations with the BODE index in COPD patients. Folia Med (Plovdiv) 2006;48:18-22.

13.

13. Donaldson GC, Wedzicha JA. COPD exacerbations. 1: Epidemiology. Thorax 2006;61:164-8.

14.

14. Vestbo J, Edwards LD, Scanlon PD, Yates JC, Agusti A, Bakke P, et al. Changes in forced expiratory volume in 1 second over time in COPD. N Engl J Med 2011; 365:1184-92.

15.

15. Au DH, Bryson CL, Chien JW, Sun H, Udris EM, Evans LE, et al. The effects of smoking cessation on the risk of chronic obstructive pulmonary disease exacerbations. J Gen Intern Med 2009;24:457-63.

16.

16. Erdbruegger U, Haubitz M, Woywodt A. Circulating endothelial cells: a novel marker of endothelial damage. Clin Chim Acta 2006;373:17-26.

17.

17. Mutin M, Canavy I, Blann A, Bory M, Sampol J, Dignat-George F. Direct evidence of endothelial injury in acute myocardial infarction and unstable angina by demonstration of circulating endothelial cells. Blood 1999;93:2951-8.

18.

18. Bull TM, Golpon H, Hebbel RP, Solovey A, Cool CD, Tuder RM, et al. Circulating endothelial cells in pulmonary hypertension. Thromb Haemost 2003;90:698-703.

19.

19. Nadar SK, Lip GY, Lee KW, Blann AD. Circulating endothelial cells in acute ischaemic stroke. Thromb Haemost 2005;94:707-12.

20.

20. Camoin-Jau L, Kone-Paut I, Chabrol B, Sampol J, Dignat-George F. Circulating endothelial cells in Behcet's disease with cerebral thrombophlebitis. Thromb Haemost 2000;83:631-2.

21.

21. Clancy RM. Circulating endothelial cells and vascular injury in systemic lupus erythematosus. Curr Rheumatol Rep 2000;2:39-43.

22.

22. Mutunga M, Fulton B, Bullock R, Batchelor A, Gascoigne A, Gillespie JI, et al. Circulating endothelial cells in patients with septic shock. Am J Respir Crit Care Med 2001;163:195-200.

23.

23. Beerepoot LV, Mehra N, Vermaat JS, Zonnenberg BA, Gebbink MF, Voest EE. Increased levels of viable circulating endothelial cells are an indicator of progressive disease in cancer patients. Ann Oncol 2004;15:139-45.

24.

24. Peinado VI, Pizarro S, Barberà JA. Pulmonary vascular involvement in COPD. Chest 2008;134:808-14.

Tuberculosis & Respiratory Diseases

e-Submission OA Policy