Correction: Assessment of lung function in successfully treated tuberculosis reveals high burden of ventilatory defects and COPD.
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ABSTRACT:
SUBMITTER: Gupte AN
PROVIDER: S-EPMC6894794 | biostudies-literature | 2019
REPOSITORIES: biostudies-literature
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Correction: Assessment of lung function in successfully treated tuberculosis reveals high burden of ventilatory defects and COPD.
Gupte Akshay N AN Paradkar Mandar M Selvaraju Sriram S Thiruvengadam Kannan K Shivakumar Shri Vijay Bala Yogendra SVBY Sekar Krithikaa K Marinaik Srinivasa S Momin Ayesha A Gaikwad Archana A Natrajan Premkumar P Prithivi Munivardhan M Shivaramakrishnan Gomathy G Pradhan Neeta N Kohli Rewa R Raskar Swapnil S Jain Divyashri D Velu Rani R Karthavarayan Bharath B Lokhande Rahul R Suryavanshi Nishi N Gupte Nikhil N Murali Lakshmi L Salvi Sundeep S Checkley William W Golub Jonathan J Bollinger Robert R Mave Vidya V Padmapriyadarasini Chandrasekaran C Gupta Amita A
PloS one 20191205 12
[This corrects the article DOI: 10.1371/journal.pone.0217289.]. ...[more]
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Project description:Background: Burden, phenotype and risk-factors of lung function defects in successfully treated tuberculosis cases are unclear.Methods: We performed spirometry with bronchodilators in new drug-sensitive adult (?18 years) pulmonary tuberculosis cases during the 12 months following successful treatment in India. Airflow obstruction was defined as pre-bronchodilator FEV1/FVC<5th percentile of Global Lung Initiative mixed-ethnicity reference (lower limit of normal [LLN]). Chronic obstructive pulmonary disease (COPD) was defined as post-bronchodilator FEV1/FVC<LLN among participants with obstruction. Restrictive spirometry pattern was defined as FVC<LLN among participants without obstruction. Multivariable logistic and linear regression was used to identify risk-factors for obstruction, restriction and low lung function despite successful treatment.Results: Of the 172 participants included in the analysis, 82 (48%) were female, 22 (13%) had diabetes and 34 (20%) ever-smoked with a median (IQR) exposure of 3.5 (0.2-9.9) pack-years. Median (IQR) age and body-mass index (BMI) at enrollment was 32 (23-39) years and 18.1 (16.0-20.5) kg/m2 respectively. Airflow obstruction was detected in 42 (24%) participants; of whom 9 (21%) responded to short-acting bronchodilators and 25 (56%) had COPD; and was associated with duration of illness prior to treatment (aOR = 1.32 per 30-days, 95%CI 1.04-1.68, p = 0.02). A restrictive spirometry pattern was detected in 89 (52%) participants and was associated with female sex (aOR = 3.73, 95%CI 1.51-9.17, p = 0.004) and diabetes (aOR = 4.06, 95%CI 1.14-14.42, p = 0.03). Higher HbA1c at treatment initiation was associated with greater odds of a restrictive spirometry pattern (aOR = 1.29 per unit higher HbA1c, 95%CI 1.04 to 1.60, p = 0.02).Conclusion: We found a high burden of lung function defects and COPD in tuberculosis cases who successfully completed treatment. Screening for chronic lung diseases following treatment and linkage to respiratory health clinics should be included in the routine management plan of all tuberculosis cases in India, regardless of conventional COPD risk-factors such as older age and smoking.
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Project description:UnlabelledCOPD is associated with elevated cardiovascular risk and a potentiated ventilatory response to exercise. Enhanced carotid chemoreceptor (CC) activity/sensitivity is present in other clinical conditions, has been shown to contribute to sympathetic vasoconstrictor outflow, and is predictive of mortality. CC activity/sensitivity, and the resulting functional significance, has not been well examined in COPD. We hypothesized that CC activity/sensitivity would be elevated in COPD, and related to increased pulse wave velocity (a marker of CV risk) and the ventilatory response to exercise.Methods30 COPD patients and 10 healthy age-matched controls were examined. Participants performed baseline cardiopulmonary exercise and pulmonary function testing. CC activity was later evaluated by the drop in ventilation with breathing 100% O2, and CC sensitivity was then assessed by the ventilatory response to hypoxia (?VE/?SpO2). Peripheral arterial stiffness was subsequently evaluated by measurement of pulse wave velocity (PWV) using applanation tonometry while the subjects were breathing room air, and then following chemoreceptor inhibition by breathing 100% O2 for 2 minutes.ResultsCC activity, CC sensitivity, PWV and the ventilatory response to exercise were all increased in COPD relative to controls. CC sensitivity was related to PWV; however, neither CC activity nor CC sensitivity was related to the ventilatory response to exercise in COPD. CC inhibition by breathing 100% O2 normalized PWV in COPD, while no effect was observed in controls.ConclusionCC activity and sensitivity are elevated in COPD, and appear related to cardiovascular risk; however, CC activity/sensitivity does not contribute to the potentiated ventilatory response to exercise.
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