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Original Research: OBSTRUCTIVE LUNG DISEASES |

Dynamic Hyperinflation, Arterial Blood Oxygen, and Airway Oxidative Stress in Stable Patients With COPDHyperinflation and Oxidative Stress in COPD

Francisco García-Rio, PhD; David Romero, MD; Vanesa Lores, PhD; Raquel Casitas, MD; Angel Hernanz, PhD; Raul Galera, MD; Rodolfo Alvarez-Sala, PhD; Isabel Torres, PhD
Author and Funding Information

From the Servicio de Neumología (Drs García-Rio, Romero, Casitas, Galera, and Alvarez-Sala), Servicio de Bioquímica (Dr Hernanz), and Servicio de Radiodiagnóstico (Dr Torres), Hospital Universitario La Paz, IdiPAZ; and Sección de Neumología (Dr Lores), Hospital Infanta Leonor, Madrid, Spain.

Correspondence to: Francisco García-Rio, Alfredo Marquerie 11, iqda, 1° A, 28034-Madrid, Spain; e-mail: fgr01m@gmail.com


Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(4):961-969. doi:10.1378/chest.10-2788
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Background:  There is considerable evidence that oxidative stress is increased in patients with COPD, although little information is available about its relationship with the structural and functional alterations produced by COPD. In this study, we evaluated the relationship between 8-isoprostane in exhaled breath condensate (EBC) of stable patients with COPD and the main parameters of the disease (such as dyspnea), stages of severity, lung parenchyma densities, lung function impairment, and exercise tolerance in order to identify the predictors of airway oxidative stress.

Methods:  In a cross-sectional study, we included 76 men with moderate to very severe COPD. 8-Isoprostane levels in EBC were measured by enzyme immunoassay. Regional lung densities were measured by lung densitometry with high-resolution CT scanning. Arterial blood gas levels, lung volumes, and diffusing capacity were determined. Patients performed a 6-min walk test and an incremental exercise test with measurement of breathing pattern and operating lung volumes.

Results:  Significant severity-related differences in 8-isoprostane were identified according to the BMI, obstruction, dyspnea, and exercise (BODE) index. 8-Isoprostane levels were related to smoking intensity, lung densities in expiration, static lung volumes, Pao2, diffusion capacity, distance walked in 6 min, peak oxygen uptake, and anaerobic threshold. Concentration of 8-isoprostane was higher in the 60 patients (79%) who developed dynamic hyperinflation than in the remaining 16 (21%) who did not. In a multivariate linear regression analysis using 8-isoprostane as a dependent variable, end-expiratory lung volume change and Pao2 were retained in the prediction model (r2 = 0.734, P < .001).

Conclusions:  In stable patients with COPD, oxygen level and dynamic hyperinflation are related to airway oxidative stress.

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