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Multicenter Study
. 2015 Oct;30(10):1459-65.
doi: 10.3346/jkms.2015.30.10.1459. Epub 2015 Sep 12.

The Prognostic Value of Residual Volume/Total Lung Capacity in Patients with Chronic Obstructive Pulmonary Disease

Tae Rim Shin  1 , Yeon-Mok Oh  2 , Joo Hun Park  3 , Keu Sung Lee  3 , Sunghee Oh  4 , Dae Ryoung Kang  4 , Seungsoo Sheen  3 , Joon Beom Seo  5 , Kwang Ha Yoo  6 , Ji-Hyun Lee  7 , Tae-Hyung Kim  8 , Seong Yong Lim  9 , Ho Il Yoon  10 , Chin Kook Rhee  11 , Kang-Hyeon Choe  12 , Jae Seung Lee  2 , Sang-Do Lee  2
Affiliations
Multicenter Study

The Prognostic Value of Residual Volume/Total Lung Capacity in Patients with Chronic Obstructive Pulmonary Disease

Tae Rim Shin et al. J Korean Med Sci. 2015 Oct.

Abstract

The prognostic role of resting pulmonary hyperinflation as measured by residual volume (RV)/total lung capacity (TLC) in chronic obstructive pulmonary disease (COPD) remains poorly understood. Therefore, this study aimed to identify the factors related to resting pulmonary hyperinflation in COPD and to determine whether resting pulmonary hyperinflation is a prognostic factor in COPD. In total, 353 patients with COPD in the Korean Obstructive Lung Disease cohort recruited from 16 hospitals were enrolled. Resting pulmonary hyperinflation was defined as RV/TLC ≥ 40%. Multivariate logistic regression analysis demonstrated that older age (P = 0.001), lower forced expiratory volume in 1 second (FEV1) (P < 0.001), higher St. George Respiratory Questionnaire (SGRQ) score (P = 0.019), and higher emphysema index (P = 0.010) were associated independently with resting hyperinflation. Multivariate Cox regression model that included age, gender, dyspnea scale, SGRQ, RV/TLC, and 6-min walking distance revealed that an older age (HR = 1.07, P = 0.027), a higher RV/TLC (HR = 1.04, P = 0.025), and a shorter 6-min walking distance (HR = 0.99, P < 0.001) were independent predictors of all-cause mortality. Our data showed that older age, higher emphysema index, higher SGRQ score, and lower FEV1 were associated independently with resting pulmonary hyperinflation in COPD. RV/TLC is an independent risk factor for all-cause mortality in COPD.

Keywords: COPD; Hyperinflation; Residual Volume; Survival; Total Lung Capacity.

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Conflict of interest statement

DISCLOSURE: Oh YM 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 that have been organized and financed by various pharmaceutical companies (Handok, GlaxoSmithKline, AstraZeneca Korea, MSD Korea, Novartis, and Boehringer Ingelheim). Lee SD serves as a consultant for GlaxoSmithKline and has participated as a speaker at scientific meetings that have been organized and financed by various pharmaceutical companies (GlaxoSmithKline, AstraZeneca Korea, and Boehringer Ingelheim). Other authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Flow diagram of the subjects who were enrolled in this study.
Fig. 2
Fig. 2. Rate of hyperinflators (RV/TLC ≥ 40%) according to FEV1.
Fig. 3
Fig. 3. Rate of frequent exacerbations according to RV/TLC. Frequency of frequent exacerbations in (A) the year before enrollment and (B) during the first year of follow-up. RV/TLC, residual volume/total lung capacity.
See this image and copyright information in PMC

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