CHEST Guidelines-Visual-vs-Automated-Assessment-of-Emphysema--Respo

Visual-vs-Automated-Assessment-of-Emphysema--Respo

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The document includes responses from authors of two distinct pieces in the CHEST journal. 

1. <strong>COPD Phenotyping Study Response:</strong>
   - Authors Mona Bafadhel, Christopher E. Brightling, and Salman Siddiqui respond to comments from Dr. Hochhegger and colleagues regarding their research on the multidimensional phenotyping of COPD. Their study highlights the heterogeneity of COPD and the necessity of using a multidimensional approach that integrates tools like CT scans for effective phenotyping. They acknowledge that while spirometry alone is insufficient to differentiate between radiologic phenotypes of COPD, CT scans can help, especially in early disease detection of emphysema. However, they note challenges in quantifying airway wall dimensions necessary for detecting bronchial wall thickening and bronchiectasis. 

2. <strong>Overlooking Cardiovascular Risk in COPD Patients:</strong>
   - Another letter addresses how cardiovascular risk is often overlooked in COPD patients, who are susceptible to cardiovascular issues due to chronic systemic inflammation. A retrospective analysis of 117 COPD patients revealed that a significant number of these patients either had preexisting cardiovascular diseases or were at high risk of developing them. However, a substantial portion of these patients were not prescribed recommended medications like statins or antiplatelet agents. The authors suggest that low prescription rates might be due to concerns over bleeding risks associated with anticoagulants like warfarin. They stress the importance of increasing awareness and appropriate treatment for cardiovascular risks in COPD patients, given the strong evidence supporting the benefits of statins.

Overall, both responses emphasize the complexity in managing COPD and associated conditions, underscoring the importance of comprehensive approaches in both phenotyping COPD and addressing its systemic effects, especially cardiovascular risks.

Keywords

COPD

phenotyping

cardiovascular risk

multidimensional approach

CT scans

emphysema detection

bronchial wall thickening

chronic systemic inflammation

statins

antiplatelet agents