Characterisation of COPD heterogeneity in the ECLIPSE cohort
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Open Access
- 10 September 2010
- journal article
- research article
- Published by Springer Science and Business Media LLC in Respiratory Research
- Vol. 11 (1), 122
- https://doi.org/10.1186/1465-9921-11-122
Abstract
Chronic obstructive pulmonary disease (COPD) is a complex condition with pulmonary and extra-pulmonary manifestations. This study describes the heterogeneity of COPD in a large and well characterised and controlled COPD cohort (ECLIPSE). We studied 2164 clinically stable COPD patients, 337 smokers with normal lung function and 245 never smokers. In these individuals, we measured clinical parameters, nutritional status, spirometry, exercise tolerance, and amount of emphysema by computed tomography. COPD patients were slightly older than controls and had more pack years of smoking than smokers with normal lung function. Co-morbidities were more prevalent in COPD patients than in controls, and occurred to the same extent irrespective of the GOLD stage. The severity of airflow limitation in COPD patients was poorly related to the degree of breathlessness, health status, presence of co-morbidity, exercise capacity and number of exacerbations reported in the year before the study. The distribution of these variables within each GOLD stage was wide. Even in subjects with severe airflow obstruction, a substantial proportion did not report symptoms, exacerbations or exercise limitation. The amount of emphysema increased with GOLD severity. The prevalence of bronchiectasis was low (4%) but also increased with GOLD stage. Some gender differences were also identified. The clinical manifestations of COPD are highly variable and the degree of airflow limitation does not capture the heterogeneity of the disease.Keywords
This publication has 28 references indexed in Scilit:
- Management of stable chronic obstructive pulmonary disease in primary and secondary care: summary of updated NICE guidanceBMJ, 2010
- Clinical COPD phenotypes: a novel approach using principal component and cluster analysesEuropean Respiratory Journal, 2010
- Systemic manifestations and comorbidities of COPDEuropean Respiratory Journal, 2009
- Associations of IL6 polymorphisms with lung function decline and COPDThorax, 2009
- Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE)European Respiratory Journal, 2008
- Gender and Chronic Obstructive Pulmonary DiseaseAmerican Journal of Respiratory and Critical Care Medicine, 2007
- Accelerated Variant of Idiopathic Pulmonary Fibrosis: Clinical Behavior and Gene Expression PatternPLOS ONE, 2007
- NICE guidance for COPDThorax, 2004
- The heterogeneity of chronic obstructive pulmonary diseaseThorax, 2000
- The natural history of chronic airflow obstruction.BMJ, 1977