PMID- 25952774
OWN - NLM
STAT- MEDLINE
DCOM- 20160308
LR  - 20150613
IS  - 1532-3064 (Electronic)
IS  - 0954-6111 (Linking)
VI  - 109
IP  - 7
DP  - 2015 Jul
TI  - Emphysema and DLCO predict a clinically important difference for 6MWD decline in 
      COPD.
PG  - 882-9
LID - S0954-6111(15)00120-1 [pii]
LID - 10.1016/j.rmed.2015.04.009 [doi]
AB  - BACKGROUND: Exercise impairment is a central feature of chronic obstructive 
      pulmonary disease (COPD), and a minimal clinically important difference (MCID) 
      for 6-min walk distance (6MWD) decline (>30 m) has been associated with increased 
      mortality. The predictors of the MCID are not fully known. We hypothesize that 
      physiological factors and radiographic measures predict the MCID. METHODS: We 
      assessed 121 COPD subjects during 2 years using clinical variables, computed 
      tomographic (CT) measures of emphysema, and functional measures including 
      diffusion lung capacity for carbon monoxide (DLCO). The association between an 
      MCID for 6MWD and clinical, CT, and physiologic predictors was assessed using 
      logistic analysis. The C-statistic was used to assess the predictive ability of 
      the models. RESULTS: Forty seven (39%) subjects had an MCID. In an imaging-based 
      model, log emphysema and age were the best predictors of MCID (emphysema Odds 
      Ratio [OR] 2.47 95%CI [1.28-4.76]). In a physiologic model, DLCO, age, and male 
      gender were selected the best predictors (DLCO OR 1.19 [1.08-1.31]). The 
      C-statistic for the ability of these models to predict an MCID was 0.71 and 0.75, 
      respectively. CONCLUSION: In COPD patients the burden of emphysema on CT scan and 
      DLCO predict a clinically meaningful decline in exercise capacity.
CI  - Copyright (c) 2015 Elsevier Ltd. All rights reserved.
FAU - Diaz, Alejandro A
AU  - Diaz AA
AD  - Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, 
      Harvard Medical School, Boston, MA, USA.
FAU - Pinto-Plata, Victor
AU  - Pinto-Plata V
AD  - Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, 
      Harvard Medical School, Boston, MA, USA.
FAU - Hernandez, Camila
AU  - Hernandez C
AD  - Department of Pulmonary Diseases, Facultad de Medicina, Pontificia Universidad 
      Catolica de Chile, Santiago, Chile.
FAU - Pena, Javier
AU  - Pena J
AD  - Department of Pulmonary Diseases, Facultad de Medicina, Pontificia Universidad 
      Catolica de Chile, Santiago, Chile.
FAU - Ramos, Cristobal
AU  - Ramos C
AD  - Department of Radiology, Hospital Clinico Jose Joaquin Aguirre, Universidad de 
      Chile, Santiago, Chile.
FAU - Diaz, Juan C
AU  - Diaz JC
AD  - Department of Radiology, Hospital Clinico Jose Joaquin Aguirre, Universidad de 
      Chile, Santiago, Chile.
FAU - Klaassen, Julieta
AU  - Klaassen J
AD  - Department of Diabetes, Nutrition and Metabolism, Facultad de Medicina, 
      Pontificia Universidad Catolica de Chile, Santiago, Chile.
FAU - Patino, Cecilia M
AU  - Patino CM
AD  - Department of Preventive Medicine, Keck School of Medicine, University of 
      Southern California, Los Angeles, CA, USA.
FAU - Saldias, Fernando
AU  - Saldias F
AD  - Department of Pulmonary Diseases, Facultad de Medicina, Pontificia Universidad 
      Catolica de Chile, Santiago, Chile.
FAU - Diaz, Orlando
AU  - Diaz O
AD  - Department of Pulmonary Diseases, Facultad de Medicina, Pontificia Universidad 
      Catolica de Chile, Santiago, Chile. Electronic address: odiazp@vtr.net.
LA  - eng
GR  - HL118714/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20150423
PL  - England
TA  - Respir Med
JT  - Respiratory medicine
JID - 8908438
RN  - 7U1EE4V452 (Carbon Monoxide)
SB  - IM
MH  - Aged
MH  - Carbon Monoxide/*metabolism
MH  - Exercise Tolerance/*physiology
MH  - Female
MH  - Follow-Up Studies
MH  - Forced Expiratory Volume
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Pulmonary Diffusing Capacity/*methods
MH  - Pulmonary Disease, Chronic Obstructive/complications/metabolism/*physiopathology
MH  - Pulmonary Emphysema/diagnosis/*etiology/physiopathology
MH  - Tomography, X-Ray Computed
MH  - *Walking
OTO - NOTNLM
OT  - %LAA
OT  - COPD
OT  - CT
OT  - Emphysema
OT  - Six-minute walk distance
EDAT- 2015/05/09 06:00
MHDA- 2016/03/10 06:00
CRDT- 2015/05/09 06:00
PHST- 2014/12/12 00:00 [received]
PHST- 2015/03/17 00:00 [revised]
PHST- 2015/04/14 00:00 [accepted]
PHST- 2015/05/09 06:00 [entrez]
PHST- 2015/05/09 06:00 [pubmed]
PHST- 2016/03/10 06:00 [medline]
AID - S0954-6111(15)00120-1 [pii]
AID - 10.1016/j.rmed.2015.04.009 [doi]
PST - ppublish
SO  - Respir Med. 2015 Jul;109(7):882-9. doi: 10.1016/j.rmed.2015.04.009. Epub 2015 Apr 
      23.