Influence of radiological emphysema on lung function test in idiopathic pulmonary fibrosis

Bodlet, Aline; Maury, Guy; Jamart, Jacques; Dahlqvist, Caroline

doi:10.1016/j.rmed.2013.08.039

Cited by 34 publications

(30 citation statements)

References 25 publications

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“…In general, the prevalence of PH was similar in studies from Europe [18,25,[40][41][42][43][44][45][47][48][49], North America [5,6,26,28,46,[50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67], Asia and Africa [37,[68][69][70][71][72][73][74][75], although the majority of evidence was reported from North America (n=23, 53%). Across studies, the prevalence of PH among IPF patients ranged from 3% to 86%; most estimates tended to be between 30% and 50% (figure 3) [25, 43, 44, 47, 50, 52-66, 68, 71-73].…”

Section: Pulmonary Hypertensionmentioning

confidence: 85%

“…The prevalence of COPD (including emphysema) was reported in 23 studies (online supplementary table S1), of which eight were from Europe [18][19][20][21][22][23][24][25], eight were from North America [6,[26][27][28][29][30][31][32], six were from Asia [33][34][35][36][37][38] and one was from South America (Brazil) [39]. The reported prevalence of COPD ranged from 6% to 67% (figure 2) ( prevalence ranges by country: 12% [21] to 51% [18] in Europe, 8% [26] to 67% [31] in North America and 34% [36] to 65% [34] in Asia).…”

Section: Respiratory Comorbidities Copdmentioning

confidence: 99%

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Comorbidities in idiopathic pulmonary fibrosis patients: a systematic literature review

et al. 2015

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Idiopathic pulmonary fibrosis (IPF) is associated with a fatal prognosis and manifests in patients over 60 years old who may have comorbidities. The prevalence and impact of comorbidities on the clinical course of IPF is unclear.This systematic literature review examined the prevalence of comorbidities and mortality associated with comorbidities in IPF patients. Relevant observational studies published in English from January 1990 to January 2015 identified via MEDLINE and EMBASE were included; bibliographies of articles were also searched.Among the 126 studies included, prevalence of pulmonary hypertension (PH) was 3-86%, 6-91% for obstructive sleep apnoea, 3-48% for lung cancer and 6-67% for chronic obstructive pulmonary disease (COPD). Nonrespiratory comorbidities included ischaemic heart disease (IHD) (3-68%) and gastrooesophageal reflux (GER) (0-94%). Mortality was highest among patients with IPF and lung cancer. Most studies assessed relatively small samples of patients with IPF.PH, COPD, lung cancer, GER and IHD are significant comorbidities; differences in IPF severity, case definitions and patient characteristics limited the comparability of findings. The identification and prompt treatment of comorbidities may have a clinically significant impact on overall outcome that is meaningful for patients with IPF. @ERSpublications Identification and prompt treatment of comorbidities has a clinically significant impact on outcome for IPF patients

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Section: Pulmonary Hypertensionmentioning

confidence: 85%

Section: Respiratory Comorbidities Copdmentioning

confidence: 99%

Comorbidities in idiopathic pulmonary fibrosis patients: a systematic literature review

et al. 2015

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“…The prevalence of emphysema in patients with IPF, which defines the CPFE syndrome, ranges from 6% to 67% [100]. Emphysema is associated with higher FVC and TLC at diagnosis in patients with IPF [102]. CPFE is associated with markedly lower DLCO, especially when emphysema is present in lung areas not affected by fibrosis [103].…”

Section: Impact Of Comorbidities On Lung Function In Ipfmentioning

confidence: 99%

Physiology of the lung in idiopathic pulmonary fibrosis

et al. 2018

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The clinical expression of idiopathic pulmonary fibrosis (IPF) is directly related to multiple alterations in lung function. These alterations derive from a complex disease process affecting all compartments of the lower respiratory system, from the conducting airways to the lung vasculature. In this article we review the profound alterations in lung mechanics (reduced lung compliance and lung volumes), pulmonary gas exchange (reduced diffusing capacity, increased dead space ventilation, chronic arterial hypoxaemia) and airway physiology (increased cough reflex and increased airway volume), as well as pulmonary haemodynamics related to IPF. The relative contribution of these alterations to exertional limitation and dyspnoea in IPF is discussed.

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“…The basis for a poor outcome is suggested to be partly related to an increased predisposition to the development of pulmonary hypertension (PHT) [7,10,11]. However, subsequent analyses of CPFE cohorts have provided conflicting data on the survival implications of emphysema co-existing with fibrosis [4,[12][13][14][15]. Moreover, the question of whether the co-existence of pulmonary fibrosis and emphysema constitutes a discreet clinical syndrome remains unresolved [16,17].…”

Section: Introductionmentioning

confidence: 99%

Functional and prognostic effects when emphysema complicates idiopathic pulmonary fibrosis

et al. 2017

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This study aimed to investigate whether the combination of fibrosis and emphysema has a greater effect than the sum of its parts on functional indices and outcome in idiopathic pulmonary fibrosis (IPF), using visual and computer-based (CALIPER) computed tomography (CT) analysis.Consecutive patients (n=272) with a multidisciplinary IPF diagnosis had the extent of interstitial lung disease (ILD) scored visually and by CALIPER. Visually scored emphysema was subcategorised as isolated or mixed with fibrotic lung. The CT scores were evaluated against functional indices forced vital capacity (FVC), diffusing capacity of the lungs for carbon monoxide (), transfer coefficient of the lung for carbon monoxide (), composite physiologic index (CPI)) and mortality.The presence and extent of emphysema had no impact on survival. Results were maintained following correction for age, gender, smoking status and baseline severity using , and combined visual emphysema and ILD extent. Visual emphysema quantitation indicated that relative preservation of lung volumes (FVC) resulted from tractionally dilated airways within fibrotic lung, ventilating areas of admixed emphysema (p<0.0001), with no independent effect on FVC from isolated emphysema. Conversely, only isolated emphysema (p<0.0001) reduced gas transfer ().There is no prognostic impact of emphysema in IPF, beyond that explained by the additive extents of both fibrosis and emphysema. With respect to the location of pulmonary fibrosis, emphysema distribution determines the functional effects of emphysema.

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Influence of radiological emphysema on lung function test in idiopathic pulmonary fibrosis

Cited by 34 publications

References 25 publications

Comorbidities in idiopathic pulmonary fibrosis patients: a systematic literature review

Comorbidities in idiopathic pulmonary fibrosis patients: a systematic literature review

Physiology of the lung in idiopathic pulmonary fibrosis

Functional and prognostic effects when emphysema complicates idiopathic pulmonary fibrosis

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