The Impact of Emphysema on Chronic Obstructive Pulmonary Diseases

Abstract

Emphysema is defined as an abnormal and permanent enlargement of the air spaces distal to the terminal bronchioles that is accompanied by destruction of the air space walls, with no obvious fibrosis (i.e. there is no fibrosis visible to the naked eye) and it is usually associated to tobacco smoking. Although it is included in the pathological definition of chronic obstructive pulmonary disease (COPD), not all COPD patients have emphysema and its impact on the clinical presentation and the natural history of the disease is variable. The present review will cover the prevalence of emphysema in COPD patients, its impact on the clinical presentation, association with comorbidities and the main outcomes of the disease: exacerbations, lung function decline and mortality. In this review, we will only evaluate the relationship of tobacco-related emphysema with COPD. (BRN Rev. 2017;3:235-46)