Abstract:
BACKGROUND:COPD is a heterogeneous disease characterized by airflow obstruction and diagnosed by lung function. CT imaging is emerging as an important, noninvasive tool in phenotyping COPD. However, the use of CT imaging in defining the disease heterogeneity above lung function is not fully known. METHODS:Seventy-five patients with COPD (58 men, 17 women) were studied with CT imaging and with measures of airway inflammation. Airway physiology and health status were also determined. RESULTS:The presence of emphysema (EM), bronchiectasis (BE), and bronchial wall thickening (BWT) was found in 67%, 27%, and 27% of subjects, respectively. The presence of EM was associated with lower lung function (mean difference % FEV(1), -20%; 95% CI, -28 to -11; P < .001). There was no difference in airway inflammation, exacerbation frequency, or bacterial load in patients with EM alone or with BE and/or BWT ± EM. The diffusing capacity of the lung for carbon monoxide/alveolar volume ratio was the most sensitive and specific parameter in identifying EM (area under the receiver operator characteristic curve, 0.87; 95% CI, 0.79-0.96). Physiologic cluster analysis identified three clusters, two of which were EM predominant and the third characterized by a heterogeneous combination of EM and BE. CONCLUSIONS:The application of CT imaging can be useful as a tool in the multidimensional approach to phenotyping patients with COPD.
journal_name
Chestjournal_title
Chestauthors
Bafadhel M,Umar I,Gupta S,Raj JV,Vara DD,Entwisle JJ,Pavord ID,Brightling CE,Siddiqui Sdoi
10.1378/chest.10-3007subject
Has Abstractpub_date
2011-09-01 00:00:00pages
634-642issue
3eissn
0012-3692issn
1931-3543pii
S0012-3692(11)60468-6journal_volume
140pub_type
杂志文章相关文献
CHEST文献大全abstract:BACKGROUND:Pulmonary edema may alter alveolar bacterial clearance and infectivity. Manipulation of fluid balance aimed at reducing fluid overload may, therefore, influence ventilator-associated pneumonia (VAP) occurrence in intubated patients. The objective of the present study was to assess the impact of a depletive f...
journal_title:Chest
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1378/chest.13-2564
更新日期:2014-07-01 00:00:00
abstract:STUDY OBJECTIVES:We set out to determine whether there is a difference in postoperative pain and recovery after the patient undergoes the axillary muscle-sparing incision (ie, muscle-sparing thoracotomy [MT]) vs the modified posterolateral incision (ie, posterolateral thoracotomy [PT]). DESIGN:Analysis of a database o...
journal_title:Chest
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1378/chest.128.4.2664
更新日期:2005-10-01 00:00:00
abstract::To assess the clinical correlates and therapeutic outcome of new postoperative supraventricular tachyarrhythmias, 916 patients who were in sinus rhythm throughout the course of surgery were prospectively followed after major noncardiac surgery. The 35 patients (4 percent) who developed new postoperative supraventricul...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.73.4.450
更新日期:1978-04-01 00:00:00
abstract::A five-year clinical follow-up and the results of myocardial biopsies are described in a patient with primary restrictive cardiomyopathy. Histologic examination of a right ventricular endomyocardial biopsy taken early in the course of the illness was not contributory. Histologic examination of a left ventricular endom...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.84.2.236
更新日期:1983-08-01 00:00:00
abstract::A nationwide study of acute myocardial infarction in Israel was carried out during a one-year period. There were 2,504 new and 968 repeated attacks. Annual incidence rate of first attacks was 0.9 per 1,000 (1.3 in men and 0.5 in women). Incidence was highest among the European born in both sexes. But, while the patter...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.68.2.214
更新日期:1975-08-01 00:00:00
abstract::Using recently published data, a nomogram was constructed to estimate the likelihood of asthma following methacholine challenge. Based on Bayes' theorem, the nomogram makes use of the sensitivity and specificity of methacholine challenge to calculate the post-test probability of asthma once the physician makes a deter...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.97.3.562
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:The optimal antithrombotic therapy strategy for atrial fibrillation (AF) patients who undergo percutaneous coronary intervention with stent implantation (PCI-S) is unknown. We assessed the safety of antithrombotic therapy strategies in AF patients with indication for oral anticoagulation (OAC) undergoing PCI...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-0350
更新日期:2008-09-01 00:00:00
abstract:STUDY OBJECTIVES:To analyze the outcome of acute respiratory failure (ARF) in patients with idiopathic pulmonary fibrosis (IPF), and to evaluate the benefits of invasive and noninvasive mechanical ventilation (MV). DESIGN:Retrospective study. SETTING:University hospital. PATIENTS:Fifteen consecutive patients with IP...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.120.1.209
更新日期:2001-07-01 00:00:00
abstract::Persistent minor hemoptysis resulted from extensive granulation tissue on the main carina and adjacent bronchi due to frequent spraying of metered-dose inhaler (MDI)-generated aerosol medications directly into a permanent tracheostomy. Salbutamol, containing oleic acid, was considered the most likely cause. After an A...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.115.1.279
更新日期:1999-01-01 00:00:00
abstract:STUDY OBJECTIVE:Our group performed a randomized trial to assess whether the addition of endobronchial ultrasound (EBUS) guidance will lead to better results than standard transbronchial needle aspiration (TBNS). EBUS guidance seems to be beneficial in increasing the yield of TBNA but has not been proven to be superior...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.125.1.322
更新日期:2004-01-01 00:00:00
abstract::Endothelial metabolism of L-arginine to L-citrulline and the potent vasodilator, nitric oxide (NO), is important in the regulation of vascular tone and resting BP. L-arginine improves abnormal endothelium-dependent vasodilation in the setting of hypercholesterolemia and has a vasodilatory effect in normal vessels, eff...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.109.6.1550
更新日期:1996-06-01 00:00:00
abstract:STUDY OBJECTIVES:To describe the health-related quality of life (HRQL) and mental health of persons with sarcoidosis, as well as to assess physician-patient agreement about the presence of sarcoidosis symptoms. DESIGN AND SETTING:Cross-sectional study at three university medical center outpatient pulmonary clinics. P...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.125.3.997
更新日期:2004-03-01 00:00:00
abstract:STUDY OBJECTIVE:To identify the prognostic factors for pneumothorax in patients in the ICU. DESIGN:Retrospective cohort study. SETTING:ICU at a university-based teaching hospital. PATIENTS AND METHODS:Sixty patients developed pneumothoraces in the ICU during a period of 36 months. Medical records relating to patient...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.122.2.678
更新日期:2002-08-01 00:00:00
abstract::Congenital diaphragmatic hernia (CDH) is associated with a variety of cardiac anomalies. However, its association with hypoplastic left heart syndrome (HLHS) is rare. We treated a female newborn with CDH, HLHS, and omphalocele. The operation for omphalocele and the diaphragmatic defect was successful, although the pat...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.101.1.263
更新日期:1992-01-01 00:00:00
abstract::To evaluate measurements of respiratory sensation in ILD, we compared ratings of breathlessness from three clinical scales with the perceived magnitude of added elastic loads in 20 symptomatic ILD patients. Dyspnea ratings were obtained by two independent observers for each clinical method. Perceived magnitude of four...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.96.4.767
更新日期:1989-10-01 00:00:00
abstract::We wanted to determine the long-term effects of a continuous infusion of PGE1 on DO2 and VO2 in patients with ARDS. Data were obtained from a randomized double-blind multicenter trial, which evaluated the effects of PGE1 on survival in patients with ARDS. Patients were stratified according to treatment and outcome: pl...
journal_title:Chest
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1378/chest.98.2.405
更新日期:1990-08-01 00:00:00
abstract::Proximal pulmonary artery aneurysms (PAAs) are rare. Most are associated with secondary pulmonary hypertension or a variety of rare systemic disorders. An asymptomatic adult patient presented with bilateral hilar enlargement on a routine chest roentgenogram. Computed tomography of the chest revealed 5 cm bilateral pro...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.102.1.311
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:Malignant pleural effusion (MPE) is common. Existing literature on pleural fluid compositions is restricted to cross-sectional sampling with little information on longitudinal changes of fluid biochemistry and cytokines with disease progression. Indwelling pleural catheters provide the unique opportunity for...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2016.01.001
更新日期:2016-06-01 00:00:00
abstract::Sleep health is a multidimensional construct that includes adequate duration, quality, and appropriately timed sleep that may be influenced by environmental factors. In this review, we focus on how an individual's living and sleeping environment, both the surrounding neighborhood physical and social features and the a...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1016/j.chest.2019.12.002
更新日期:2020-05-01 00:00:00
abstract::Hemodynamic and oxygen transport effects of PGE1 were observed in the early postoperative period before development of ARDS in two series of general surgical patients with circulatory deficiencies. The first was a series of 19 studies in 18 patients, the second was a placebo-controlled series of 20 patients (ten recei...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.99.4.945
更新日期:1991-04-01 00:00:00
abstract::Angiosarcoma in the lung is an uncommon disorder and is usually attributable to metastasis from a primary site. Primary pulmonary angiosarcoma is extremely rare, and the prognosis of affected individuals is dismal, with most patients dying within months of presentation. Indeed, there have been no reported instances of...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.124.6.2397
更新日期:2003-12-01 00:00:00
abstract::Volatile organic compounds (VOCs) are produced by virtually all metabolic processes of the body. As such, they have potential to serve as noninvasive metabolic biomarkers. Since exhaled VOCs are either derived from the respiratory tract itself or have passed the lungs from the circulation, they are candidate biomarker...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.14-0781
更新日期:2015-01-01 00:00:00
abstract::Mitral, aortic, and coronary arterial disease have been described in the various mucopolysaccharidoses. We report the first successful combined aortic and mitral valve replacement in an adult female patient with severe aortic and mitral stenosis due to Scheie's syndrome, a mucopolysaccharide storage disease. Both annu...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.96.1.209
更新日期:1989-07-01 00:00:00
abstract::Bronchoscopic examination to diagnose lung metastases has not been as rewarding as in primary lung cancer. Despite a lower expected yield, we believe the procedure has value in certain patients, ie, those with clinical findings of endobronchial disease. To determine better the value of bronchoscopy in this population,...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.88.1.84
更新日期:1985-07-01 00:00:00
abstract:BACKGROUND:A novel approach to estimate the severity of COPD exacerbation and predict its outcome is the use of biomarkers. We assessed circulating levels of copeptin, the precursor of vasopressin, C-reactive protein (CRP), and procalcitonin as potential prognostic parameters for in-hospital and long-term outcomes in p...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.06-2336
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:The impact of sleep apnea on work disability, in terms of sickness absence and disability pension, is unclear. We sought to estimate the total number of lost workdays caused by sleep apnea either due to medically certified sickness absences or disability pensions during the 5 years prior to the year of a sle...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-2201
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:The objective of this study was to systematically review and quantitatively synthesize all randomized controlled trials (RCTs), comparing important outcomes in ventilated critically ill patients who received an early or late tracheotomy. METHODS:A systematic literature search of PubMed, Cumulative Index to ...
journal_title:Chest
pub_type: 杂志文章,meta分析,评审
doi:10.1378/chest.11-2024
更新日期:2011-12-01 00:00:00
abstract:STUDY OBJECTIVES:The objectives of this study are as follows: (1) to determine the incidence of complications from thoracentesis performed under ultrasound guidance by interventional radiologists in a tertiary referral teaching hospital; (2) to evaluate the incidence of vasovagal events without the use of atropine prio...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.123.2.418
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Although alveolar epithelial injury is a major determinant of outcome in patients with acute lung injury, there is no reliable biological marker of alveolar epithelial injury. The primary objective was to determine whether elevated levels of the receptor for advanced glycation end products (RAGE), a marker o...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-0919
更新日期:2009-02-01 00:00:00
abstract::Acute hypoxemic respiratory failure (AHRF) can result from diverse lung insults. Toxic oxygen metabolites have been implicated in this clinical condition and in animal models of pulmonary edema. Hydrogen peroxide (H2O2), an oxygen metabolite, mediates tissue injury. We measured H2O2 levels by a spectrophotometric tech...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.96.3.606
更新日期:1989-09-01 00:00:00