The relationship of bronchiectasis to airway obstruction and inflammation in patients with chronic obstructive pulmonary disease

Background: Chronic obstructive pulmonary disease (COPD) and bronchiectasis are diseases of respiratory tract with significant mortality and morbidity. These two diseases can be seen together occasionally and are thought to change each other's course by adversely affecting the prognosis. The aim of our study was to identify the signs of bronchiectasis in COPD patients, to investigate its possible effects on disease prognosis, and to evaluate these signs for diagnostic convenience. Materials and Methods: This prospective study included a total of s[table 60] moderate/severe COPD patients who were admitted to Yedikule Chest Diseases and Chest Surgery Training and Research Hospital between January 2015 and February 2016. The patients were divided into two groups according to the presence of bronchiectasis as confirmed radiologically: 35 patients in the bronchiectasis group and 25 patients in the control group. Demographic data of the patients were questioned and systemic inflammation parameters, spirometric measurements, blood gas analysis, and clinical evaluation findings were recorded. Results: Bronchiectasis was detected in 58.3% of COPD patients. Patients in two groups are similar in sociodemographical, spirometrical and clinical parameters (P > 0.05). Laboratory tests showed similar result in between two groups but carbon dioxide(CO2) values in the blood gas analysis were found to be higher in the bronchiectasis group (P < 0.05). The increase in the number of bronchiectasis segments was shown to reduce the FEV1/FVC (P < 0.05). In the overall evaluation, FEV1%, mMRC, FVC% and CRP levels were found to be associated with exacerbations in COPD (P < 0.05). The use of antibiotics increased as FEV1% and FEV1/FVC levels of patients decreased (P < 0.05). In addition, sputum polymorphonuclear leukocyte (PMNL) values were correlated with spirometric values and as sputum PMNL values increased, spirometric values were found to decrease (P < 0.05 for FEV1% and FVC%). Conclusion: Bronchiectasis is common in COPD patients. In two divided groups, blood gas carbon dioxide values, which affect mortality, were shown to be higher in the bronchiectasis group. This is a new addition to literature that bronchiectatic COPD patients are experiencing different respiratory failure patterns affecting mortality. Diffuse type bronchiectasis has more effect in spirometric results of COPD patients. Also, airway obstruction in COPD is well correlated with elevated sputum PMNL values which represent airway inflammation and if this is combined with high clinical suspicion it guides to a cost effective way for guiding radiological investigations for bronchiectasis

Carotid intima-media thickness in chronic obstructive pulmonary disease and survival: A multicenter prospective study

Introduction Chronic obstructive pulmonary disease (COPD) is associated with increased cardiovascular morbidity and mortality. Carotid intima-media thickness (CIMT) is a noninvasive method assessing atherosclerosis. Objective It was aimed to determine relationship and survival between COPD and CIMT. Methods CIMT was measured using Doppler ultrasound (USG) in 668 stable COPD patients at 24 centers. Patients were followed-up for 2 years. Results There were 610 patients who completed the study. There were 200 patients CIMT with = 0.78 mm (group 2). There was a significant difference at the parameters of age, gender, smoking load, biomass exposure, GOLD groups and degree of airway obstruction (FEV1) between groups 1 and 2. Our results revealed positive correlations between mean CIMT and age, smoking load (pack-years), biomass exposure (years), exacerbation rate (last year), duration of hypertension (years) and cholesterol level; negative correlations between CIMT and FEV1 (P 0.05). Conclusion This study is the first regarding CIMT with combined GOLD assessment groups. It has revealed important findings supporting the increase in atherosclerosis risk in COPD patients. We recommend Doppler USG of the carotid artery in COPD patients at severe stages