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- Title
Monitoring small airway dysfunction in connective tissue disease-related interstitial lung disease: a retrospective and prospective study.
- Authors
Xu, Linrui; Sgalla, Giacomo; Wang, Faping; Zhu, Min; Li, Liangyuan; Li, Ping; Xie, Qibing; Lv, Xiaoyan; Yu, Jianqun; Wang, Gang; Wan, Huajing; Richeldi, Luca; Luo, Fengming
- Abstract
Background: Small airway dysfunction (SAD), a hallmark of early lung function abnormality, is a major component of several chronic respiratory disorders. The role of SAD in patients with connective tissue disease-related interstitial lung disease (CTD-ILD) has not been explored. Methods: We conducted a two-parts (retrospective and prospective) study to collect pulmonary function tests from CTD-ILD patients. SAD was defined as at least two of the three measures (MMEF, FEF 50%, and FEF 75%) must be 65% of predicted values. Spearman correlation coefficient was used to evaluate association between SAD and other pulmonary function parameters. Mixed effects regression modeling analysis was used to assess response to treatment. Results: CTD-ILD patients with SAD and without SAD were compared in this study. In the retrospective study, pulmonary function tests (PFTs) from 491 CTD-ILD patients were evaluated, SAD were identified in 233 (47.5%). CTD-ILD patients with SAD were less smokers (17.6% vs. 27.9%, p = 0.007) and more females (74.3% vs. 64.0%, p = 0.015) than those without SAD. CTD-ILD patients with SAD had lower vital capacity (% predicted FVC, 70.4 ± 18.3 vs. 80.0 ± 20.9, p < 0.001) and lower diffusion capacity (% predicted DLCO, 58.8 ± 19.7 vs. 63.8 ± 22.1, p = 0.011) than those without SAD. Among 87 CTD-ILD patients prospectively enrolled, significant improvement in % predicted FVC was observed at 12-months follow-up (6.37 ± 1.53, p < 0.001 in patients with SAD; 5.13 ± 1.53, p = 0.002 in patients without SAD), but not in diffusion capacity and SAD parameters. Conclusion: In our cohort, about half of CTD-ILD patients have SAD, which is less frequent in smokers and more common in female patients. CTD-ILD patients with SAD have worse pulmonary function compared to those without SAD. Improvement of FVC but no improvement of SAD was observed in CTD-ILD patients after treatment.
- Subjects
INTERSTITIAL lung diseases; CONNECTIVE tissues; PULMONARY function tests; LONGITUDINAL method; AIRWAY (Anatomy)
- Publication
BMC Pulmonary Medicine, 2023, Vol 23, Issue 1, p1
- ISSN
1471-2466
- Publication type
Article
- DOI
10.1186/s12890-023-02381-z