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ABSTRACT: Rationale
Limited data on sex differences in advanced COPD are available.Objectives
To compare male and female emphysema patients with severe disease.Methods
One thousand fifty-three patients (38.8% female) evaluated for lung volume reduction surgery as part of the National Emphysema Treatment Trial were analyzed.Measurements and main results
Detailed clinical, physiological, and radiological assessment, including quantitation of emphysema severity and distribution from helical chest computed tomography, was completed. In a subgroup (n = 101), airway size and thickness was determined by histological analyses of resected tissue. Women were younger and exhibited a lower body mass index (BMI), shorter smoking history, less severe airflow obstruction, lower Dl(co) and arterial Po(2), higher arterial Pco(2), shorter six-minute walk distance, and lower maximal wattage during oxygen-supplemented cycle ergometry. For a given FEV(1)% predicted, age, number of pack-years, and proportion of emphysema, women experienced greater dyspnea, higher modified BODE, more depression, lower SF-36 mental component score, and lower quality of well-being. Overall emphysema was less severe in women, with the difference from men most evident in the outer peel of the lung. Females had thicker small airway walls relative to luminal perimeters.Conclusions
In patients with severe COPD, women, relative to men, exhibit anatomically smaller airway lumens with disproportionately thicker airway walls, and emphysema that is less extensive and characterized by smaller hole size and less peripheral involvement.
SUBMITTER: Martinez FJ
PROVIDER: S-EPMC1994221 | biostudies-literature | 2007 Aug
REPOSITORIES: biostudies-literature
Martinez Fernando J FJ Curtis Jeffrey L JL Sciurba Frank F Mumford Jeanette J Giardino Nicholas D ND Weinmann Gail G Kazerooni Ella E Murray Susan S Criner Gerard J GJ Sin Donald D DD Hogg James J Ries Andrew L AL Han MeiLan M Fishman Alfred P AP Make Barry B Hoffman Eric A EA Mohsenifar Zab Z Wise Robert R
American journal of respiratory and critical care medicine 20070412 3
<h4>Rationale</h4>Limited data on sex differences in advanced COPD are available.<h4>Objectives</h4>To compare male and female emphysema patients with severe disease.<h4>Methods</h4>One thousand fifty-three patients (38.8% female) evaluated for lung volume reduction surgery as part of the National Emphysema Treatment Trial were analyzed.<h4>Measurements and main results</h4>Detailed clinical, physiological, and radiological assessment, including quantitation of emphysema severity and distributio ...[more]