CHEST Guidelines-Natural-Course-of-the-Diffusing-Capacity-of-the-Lu

Natural-Course-of-the-Diffusing-Capacity-of-the-Lu

Pdf Summary

The study investigates the natural progression of the diffusing capacity of the lungs for carbon monoxide (DLCO) in patients with Chronic Obstructive Pulmonary Disease (COPD), emphasizing the influence of sex differences. It followed 602 smokers, including 506 with COPD and 96 without, over five years with annual monitoring of lung function not limited to DLCO. The researchers found that the DLCO in patients with COPD declined at a rate of 1.34% per year, which is significantly sharper than the 0.04% per year observed in smokers without COPD. Among the COPD patients, women demonstrated lower baseline DLCO values and a steeper annual decline compared to men, despite having higher spirometric values. This suggests that sex differences influence lung diffusion capacity progression, with women being potentially more susceptible to emphysema within COPD. The study recommends that DLCO testing in COPD patients may be clinically informative every three to four years due to the slow progression of DLCO decline. The authors conclude that longitudinal evaluation of DLCO could be instrumental in identifying disease progression and tailoring COPD management specifically to address emphysema. Furthermore, the research underscores the need to consider sex differences in COPD studies as women showed a distinctive pattern of disease progression. This study is part of the COPD History Assessment in Spain (CHAIN) and urges further investigation into the pathophysiological roles of sex differences in COPD progression across diverse cohorts.

Keywords

DLCO

COPD

sex differences

lung function

emphysema

smokers

longitudinal evaluation

disease progression

CHAIN study

spirometric values