Lung Hyperinflation as Treatable Trait in Chronic Obstructive Pulmonary Disease: A Narrative Review

Maud Koopman, Rein Posthuma, Lowie EGW Vanfleteren, Sami O Simons, Frits ME Franssen
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Abstract

Abstract: Lung hyperinflation (LH) is a common clinical feature in patients with chronic obstructive pulmonary disease (COPD). It results from a combination of reduced elastic lung recoil as a consequence of irreversible destruction of lung parenchyma and expiratory airflow limitation. LH is an important determinant of morbidity and mortality in COPD, partially independent of the degree of airflow limitation. Therefore, reducing LH has become a major target in the treatment of COPD over the last decades. Advances were made in the diagnostics of LH and several effective interventions became available. Moreover, there is increasing evidence suggesting that LH is not only an isolated feature in COPD but rather part of a distinct clinical phenotype that may require a more integrated management. This narrative review focuses on the pathophysiology and adverse consequences of LH, the assessment of LH with lung function measurements and imaging techniques and highlights LH as a treatable trait in COPD. Finally, several suggestions regarding future studies in this field are made.

Keywords: COPD, hyperinflation, treatable trait, emphysema, phenotype
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作为慢性阻塞性肺病可治疗特征的肺过度膨胀:叙述性综述
摘要:肺过度充气(LH)是慢性阻塞性肺疾病(COPD)患者常见的临床特征。它是肺实质不可逆性破坏导致肺弹性反冲力降低和呼气气流受限共同作用的结果。LH 是慢性阻塞性肺病发病率和死亡率的重要决定因素,部分与气流受限程度无关。因此,过去几十年来,降低 LH 已成为慢性阻塞性肺病治疗的主要目标。在 LH 诊断方面取得了进展,并出现了一些有效的干预措施。此外,越来越多的证据表明,LH 不仅是慢性阻塞性肺病的一个孤立特征,而是一种独特临床表型的一部分,可能需要更综合的治疗。这篇叙述性综述侧重于 LH 的病理生理学和不良后果、通过肺功能测量和成像技术对 LH 进行评估,并强调 LH 是慢性阻塞性肺病中一种可治疗的特征。最后,就该领域未来的研究提出了几点建议:慢性阻塞性肺疾病、过度充气、可治疗性状、肺气肿、表型
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来源期刊
CiteScore
5.10
自引率
10.70%
发文量
372
审稿时长
16 weeks
期刊介绍: An international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. Special focus will be given to the pathophysiological processes underlying the disease, intervention programs, patient focused education, and self management protocols. This journal is directed at specialists and healthcare professionals
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