Structure‐function Relationships: The Pathophysiology of Airflow Obstruction

Niewoehner, Dennis E.

doi:10.1002/9780470755976.ch1

Cited by 34 publications

(15 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, patients with a COPD have uneven ventilation, which results in arterial hypoxemia and hypercapnia. These functional abnormalities can be detected and quantified by pulmonary function tests, as well as by measurement of arterial blood gases (Niewoehner and Sobonya, 1989). Hypoxemia, a reduction in partial oxygen tension (PO 2 ), can be observed in practically every known pulmonary disease entity.…”

Section: Introductionmentioning

confidence: 99%

Study of auditory function in patients with chronic obstructive pulmonary diseases

et al. 2006

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 99%

Study of auditory function in patients with chronic obstructive pulmonary diseases

et al. 2006

View full text Add to dashboard Cite

“…This is likely wrong and Marsh and coworkers have suggested that only half of cases of COPD are caused by smoking (14). FEV 1 , which was the single physiologic parameter used by Fletcher and colleagues to track the natural history of COPD, may be altered by several anatomic lesions (15). These include alveolar wall destruction, the defining feature of emphysema, which leads to both loss of lung elastic recoil and loss of anatomic tethering of small airways.…”

mentioning

confidence: 99%

Natural Histories of Chronic Obstructive Pulmonary Disease

Rennard¹,

Vestbo²

2008

Proceedings of the American Thoracic Society

View full text Add to dashboard Cite

Concepts relating to the natural history of chronic obstructive pulmonary disease (COPD) arise most importantly from the classic study of Fletcher and colleagues (The Natural History of Chronic Bronchitis and Emphysema, Oxford University Press, New York, 1976). This study, which evaluated working English men over 8 years, was used to construct a proposed life-long natural history. Although this is a classic study that has greatly advanced understanding of COPD, it has a number of limitations. Its duration is relatively short compared with the duration of COPD, so it is more cross-sectional than longitudinal. It was unable to distinguish among varied ''natural histories.'' It assessed primarily the FEV 1 , and the natural history of other features of COPD is largely undescribed. With advances in understanding the clinical features of COPD and with the development of evaluating new tools to assess patients with COPD, longitudinal studies evaluating COPD in novel ways and for longer durations are needed.

show abstract

“…1,29,30 These pathologic processes may be present to variable degrees within a given individual, thus resulting in considerable pathologic heterogeneity.…”

Section: Pathology and Physiologymentioning

confidence: 99%

“…This results in air-flow limitation because of the mechanisms that maintain small airway patency during expiration. 29 The small airways, which have no supporting cartilage, maintain patency by two mechanisms. First, nearby alveolar walls are attached directly to small airways and can, by this relationship, tether them open.…”

Section: Pathology and Physiologymentioning

confidence: 99%

“…36 In addition, small airways maintain patency due to intra-luminal pressure. 29 Pressure within the lumen of small airways is generated by the elastic recoil of alveolar structures. Loss of lung elastic recoil, which develops following alveolar wall destruction, results in collapse of small airways, particularly with forced exhalation.…”

Section: Pathology and Physiologymentioning

confidence: 99%

See 1 more Smart Citation

COPD Heterogeneity: What This Will Mean in Practice

Rennard

2011

Respir Care

View full text Add to dashboard Cite

SummaryCOPD is a complex collection of conditions. All share the feature of limited expiratory air flow. It is a "disease" in the same sense as is "chronic renal failure." Like most other chronic organ failure "diseases," COPD has disparate causes, and patients are heterogeneous in their prognosis and response to treatment. Unlike many other diseases, the heterogeneity of COPD is just beginning to be described. A number of large trials funded by the National Institutes of Health and industry promise to refine the classification of COPD. Based on accurate diagnosis of COPD subtypes, novel treatments can be more effectively developed and implemented. The clinical implications of improved understanding of COPD heterogeneity will be better care and outcomes for COPD patients, which will depend on increased diagnostic accuracy and selective administration of treatments.

show abstract

Structure‐function Relationships: The Pathophysiology of Airflow Obstruction

Cited by 34 publications

References 38 publications

Study of auditory function in patients with chronic obstructive pulmonary diseases

Study of auditory function in patients with chronic obstructive pulmonary diseases

Natural Histories of Chronic Obstructive Pulmonary Disease

COPD Heterogeneity: What This Will Mean in Practice

Contact Info

Product

Resources

About