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Dynamic expiratory tracheal collapse in COPD: correlation with clinical and physiologic parameters
Phillip M Boiselle1, Gaetane Michaud2, David H Roberts3
1Center for Airway Imaging and the Departments of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
Chest
|June 23, 2012
Summary
Excessive expiratory tracheal collapse occurs in some COPD patients but doesn't correlate with disease severity. This finding suggests incidental identification may not be clinically significant for chronic obstructive pulmonary disease management.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
Background:
- Chronic Obstructive Pulmonary Disease (COPD) is a known risk factor for excessive expiratory tracheal collapse.
- The prevalence and clinical correlations of this condition in COPD patients remain underexplored.
Purpose of the Study:
- To prospectively determine the prevalence of excessive expiratory tracheal collapse in COPD patients.
- To investigate correlations between clinical and physiological parameters and the presence of excessive tracheal collapse.
Main Methods:
- 100 adult COPD patients underwent pulmonary function tests (PFTs), 6-min walk test (6MWT), St. George's Respiratory Questionnaire (SGRQ), and dynamic low-dose CT scans.
- Correlations were analyzed between percentage expiratory tracheal collapse and PFTs, 6MWT distance, and SGRQ scores.
Main Results:
- Twenty out of 100 participants exhibited excessive expiratory tracheal collapse (mean collapse 59%).
- No significant correlations were found between the degree of tracheal collapse and pulmonary function measures, total SGRQ score, or 6MWT distance.
- A weak correlation was observed between the SGRQ symptom subscale and mid-tracheal collapse (R = 0.215, P = .03).
Conclusions:
- Excessive expiratory tracheal collapse is present in a subset of COPD patients.
- The extent of tracheal collapse is independent of COPD severity and does not significantly correlate with physiological parameters.
- Incidental findings of excessive expiratory tracheal collapse in COPD patients may lack clinical significance.
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