TY - JOUR
T1 - Natural history and risk factors of obstructive changes over a 10-year period in severe asthma
AU - Matsunaga, Kazuto
AU - Akamatsu, Keiichiro
AU - Miyatake, Akihiko
AU - Ichinose, Masakazu
PY - 2013/3
Y1 - 2013/3
N2 - Background: The clinical features, physiology, and pathology of severe asthma are poorly understood. Recently, the forced vital capacity (FVC) has been shown to be reduced in severe asthma compared to mild asthma, possibly due to air trapping. However, the natural history and risk factors of obstructive change for such asthmatic patients have not been fully elucidated. Methods: We examined the data of a retrospective analysis of lung function changes over a 10-year period in 54 severe asthma patients. Results: The faster obstructive changes detected by FEV1 (forced expiratory volume in one second) were accompanied by excessive loss of FVC (r = 0.85, p < 0.0001) and the reduction in FVC was 1.2 times larger than the FEV1 change. Age, baseline FVC, exacerbation rate and oral corticosteroids use showed significantly negative correlations with the rate of annual change in FVC. Conclusions: These data indicate that the decline in FVC is more evident than FEV1 in severe asthma, suggesting that small airway susceptibility may be the cause of rapid disease progression. Aging, exacerbations of asthma, and use of systemic corticosteroids are related to excess FVC decline, particularly if FVC is still normal.
AB - Background: The clinical features, physiology, and pathology of severe asthma are poorly understood. Recently, the forced vital capacity (FVC) has been shown to be reduced in severe asthma compared to mild asthma, possibly due to air trapping. However, the natural history and risk factors of obstructive change for such asthmatic patients have not been fully elucidated. Methods: We examined the data of a retrospective analysis of lung function changes over a 10-year period in 54 severe asthma patients. Results: The faster obstructive changes detected by FEV1 (forced expiratory volume in one second) were accompanied by excessive loss of FVC (r = 0.85, p < 0.0001) and the reduction in FVC was 1.2 times larger than the FEV1 change. Age, baseline FVC, exacerbation rate and oral corticosteroids use showed significantly negative correlations with the rate of annual change in FVC. Conclusions: These data indicate that the decline in FVC is more evident than FEV1 in severe asthma, suggesting that small airway susceptibility may be the cause of rapid disease progression. Aging, exacerbations of asthma, and use of systemic corticosteroids are related to excess FVC decline, particularly if FVC is still normal.
KW - Aging
KW - Airflow limitation
KW - Airway closure
KW - Exacerbation
KW - Steroid
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U2 - 10.1016/j.rmed.2012.11.014
DO - 10.1016/j.rmed.2012.11.014
M3 - Article
C2 - 23228369
AN - SCOPUS:84874691362
VL - 107
SP - 355
EP - 360
JO - British Journal of Tuberculosis and Diseases of the Chest
JF - British Journal of Tuberculosis and Diseases of the Chest
SN - 0954-6111
IS - 3
ER -