Abstract
RATIONALE: In bronchiectasis there is a need for improved markers of lung function to determine disease severity and response to therapy.
OBJECTIVES: To assess whether the lung clearance index is a repeatable and more sensitive indicator of computed tomography (CT) scan abnormalities than spirometry in bronchiectasis.
METHODS: Thirty patients with stable bronchiectasis were recruited and lung clearance index, spirometry, and health-related quality of life measures were assessed on two occasions, 2 weeks apart when stable (study 1). A separate group of 60 patients with stable bronchiectasis was studied on a single visit with the same measurements and a CT scan (study 2).
MEASUREMENTS AND MAIN RESULTS: In study 1, the intervisit intraclass correlation coefficient for the lung clearance index was 0.94 (95% confidence interval, 0.89 to 0.97; P < 0.001). In study 2, the mean age was 62 (10) years, FEV1 76.5% predicted (18.9), lung clearance index 9.1 (2.0), and total CT score 14.1 (10.2)%. The lung clearance index was abnormal in 53 of 60 patients (88%) and FEV1 was abnormal in 37 of 60 patients (62%). FEV1 negatively correlated with the lung clearance index (r = -0.51, P < 0.0001). Across CT scores, there was a relationship with the lung clearance index, with little evidence of an effect of FEV1. There were no significant associations between the lung clearance index or FEV1 and health-related quality of life.
CONCLUSIONS: The lung clearance index is repeatable and a more sensitive measure than FEV1 in the detection of abnormalities demonstrated on CT scan. The lung clearance index has the potential to be a useful clinical and research tool in patients with bronchiectasis.
Original language | English |
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Pages (from-to) | 586-92 |
Number of pages | 7 |
Journal | American Journal of Respiratory and Critical Care Medicine |
Volume | 189 |
Issue number | 5 |
DOIs | |
Publication status | Published - 01 Mar 2014 |
Keywords
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Breath Tests
- Bronchiectasis
- Feasibility Studies
- Female
- Forced Expiratory Volume
- Humans
- Lung
- Male
- Middle Aged
- Models, Statistical
- Quality of Life
- Questionnaires
- ROC Curve
- Regression Analysis
- Respiratory Function Tests
- Sensitivity and Specificity
- Severity of Illness Index
- Spirometry
- Tomography, X-Ray Computed
- Young Adult
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Judy Bradley
- School of Medicine, Dentistry and Biomedical Sciences - Director of Clinical Research Facility
- Wellcome Wolfson Institute for Experimental Medicine
Person: Academic