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Nitric oxide diffusing capacity versus spirometry in the early diagnosis of emphysema in smokers
Summary The diffusion capacity for nitric oxide (DLNO) is independent of pulmonary capillary blood volume and equals the membrane diffusing capacity. Therefore the DLNO could be more sensitive in detecting alveolar destruction than the DLCO. We measured flow-volumes curves, DLNO, DLCO, the transfer...
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| Published in: | Respiratory medicine 2009-12, Vol.103 (12), p.1892-1897 |
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| cites | cdi_FETCH-LOGICAL-c512t-c4b970041dcb34e21aab2fe9ac3fb5125c0022af5e2100b09f8bdce1c00479a3 |
| container_end_page | 1897 |
| container_issue | 12 |
| container_start_page | 1892 |
| container_title | Respiratory medicine |
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| creator | van der Lee, I Gietema, H.A Zanen, P van Klaveren, R.J Prokop, M Lammers, J.-W.J van den Bosch, J.M.M |
| description | Summary The diffusion capacity for nitric oxide (DLNO) is independent of pulmonary capillary blood volume and equals the membrane diffusing capacity. Therefore the DLNO could be more sensitive in detecting alveolar destruction than the DLCO. We measured flow-volumes curves, DLNO, DLCO, the transfer coefficients KNO (DLNO/VA) and KCO (DLCO/VA) and performed computed tomography (CT) scans in 263 randomly selected heavy smokers. Subjects with areas ≥1% of the total lung volume showing an attenuation |
| doi_str_mv | 10.1016/j.rmed.2009.06.005 |
| format | article |
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Therefore the DLNO could be more sensitive in detecting alveolar destruction than the DLCO. We measured flow-volumes curves, DLNO, DLCO, the transfer coefficients KNO (DLNO/VA) and KCO (DLCO/VA) and performed computed tomography (CT) scans in 263 randomly selected heavy smokers. Subjects with areas ≥1% of the total lung volume showing an attenuation <−950 Hounsfield Units were considered to have emphysema. In 36 subjects emphysema was diagnosed with CT, a low KNO was present in 94 subjects, and in 95 subjects a FEV1/FVC ratio <70% was seen. The area under the ROC curve for detection CT-based emphysema was 0.894 for the KNO, 0.822 for the KCO and 0.795 for FEV1/FVC, meaning that the KNO has a slightly higher sensitivity to detect emphysema than the KCO and FEV1/FVC. The positive predictive value of KNO however was low (34.7%), while the negative predictive value of KNO was very high (98.2%), indicating an emphysema exclusion test. The DLNO/DLCO ratio is significantly higher in the study group compared to normal subjects.</description><identifier>ISSN: 0954-6111</identifier><identifier>EISSN: 1532-3064</identifier><identifier>DOI: 10.1016/j.rmed.2009.06.005</identifier><identifier>PMID: 19586765</identifier><language>eng</language><publisher>Kidlington: Elsevier Ltd</publisher><subject>Aged ; Airway management ; Biological and medical sciences ; Chronic obstructive pulmonary disease, asthma ; Confidence intervals ; COPD ; Diffusion capacity ; Emphysema ; Epidemiologic Methods ; Humans ; Hypotheses ; Lungs ; Male ; Medical imaging ; Medical sciences ; Medical screening ; Middle Aged ; Nitric oxide ; Nitric Oxide - metabolism ; Pneumology ; Pulmonary Diffusing Capacity - methods ; Pulmonary Emphysema - diagnosis ; Pulmonary Emphysema - physiopathology ; Pulmonary/Respiratory ; Smoking - adverse effects ; Spirometry ; Spirometry - methods</subject><ispartof>Respiratory medicine, 2009-12, Vol.103 (12), p.1892-1897</ispartof><rights>Elsevier Ltd</rights><rights>2009 Elsevier Ltd</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c512t-c4b970041dcb34e21aab2fe9ac3fb5125c0022af5e2100b09f8bdce1c00479a3</citedby><cites>FETCH-LOGICAL-c512t-c4b970041dcb34e21aab2fe9ac3fb5125c0022af5e2100b09f8bdce1c00479a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22167407$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19586765$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van der Lee, I</creatorcontrib><creatorcontrib>Gietema, H.A</creatorcontrib><creatorcontrib>Zanen, P</creatorcontrib><creatorcontrib>van Klaveren, R.J</creatorcontrib><creatorcontrib>Prokop, M</creatorcontrib><creatorcontrib>Lammers, J.-W.J</creatorcontrib><creatorcontrib>van den Bosch, J.M.M</creatorcontrib><title>Nitric oxide diffusing capacity versus spirometry in the early diagnosis of emphysema in smokers</title><title>Respiratory medicine</title><addtitle>Respir Med</addtitle><description>Summary The diffusion capacity for nitric oxide (DLNO) is independent of pulmonary capillary blood volume and equals the membrane diffusing capacity. Therefore the DLNO could be more sensitive in detecting alveolar destruction than the DLCO. We measured flow-volumes curves, DLNO, DLCO, the transfer coefficients KNO (DLNO/VA) and KCO (DLCO/VA) and performed computed tomography (CT) scans in 263 randomly selected heavy smokers. Subjects with areas ≥1% of the total lung volume showing an attenuation <−950 Hounsfield Units were considered to have emphysema. In 36 subjects emphysema was diagnosed with CT, a low KNO was present in 94 subjects, and in 95 subjects a FEV1/FVC ratio <70% was seen. The area under the ROC curve for detection CT-based emphysema was 0.894 for the KNO, 0.822 for the KCO and 0.795 for FEV1/FVC, meaning that the KNO has a slightly higher sensitivity to detect emphysema than the KCO and FEV1/FVC. The positive predictive value of KNO however was low (34.7%), while the negative predictive value of KNO was very high (98.2%), indicating an emphysema exclusion test. The DLNO/DLCO ratio is significantly higher in the study group compared to normal subjects.</description><subject>Aged</subject><subject>Airway management</subject><subject>Biological and medical sciences</subject><subject>Chronic obstructive pulmonary disease, asthma</subject><subject>Confidence intervals</subject><subject>COPD</subject><subject>Diffusion capacity</subject><subject>Emphysema</subject><subject>Epidemiologic Methods</subject><subject>Humans</subject><subject>Hypotheses</subject><subject>Lungs</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Medical screening</subject><subject>Middle Aged</subject><subject>Nitric oxide</subject><subject>Nitric Oxide - metabolism</subject><subject>Pneumology</subject><subject>Pulmonary Diffusing Capacity - methods</subject><subject>Pulmonary Emphysema - diagnosis</subject><subject>Pulmonary Emphysema - physiopathology</subject><subject>Pulmonary/Respiratory</subject><subject>Smoking - adverse effects</subject><subject>Spirometry</subject><subject>Spirometry - methods</subject><issn>0954-6111</issn><issn>1532-3064</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><recordid>eNp9kl2L1TAQhoMo7nH1D3ghBRGvepykadqCCLL4BYteuPcxTSe7Ods2NdMu9t-bcg4r7IVXgeR5ZyYPw9hLDnsOXL077OOA3V4ANHtQe4DyEdvxshB5AUo-ZjtoSpkrzvkZe0Z0gARKCU_ZGW_KWlWq3LFf3_0cvc3CH99h1nnnFvLjdWbNZKyf1-wOIy2U0eRjGHCOa-bHbL7BDE3s15Qw12MgT1lwGQ7TzUo4mI2hIdym7HP2xJme8MXpPGdXnz9dXXzNL398-Xbx8TK3JRdzbmXbVACSd7YtJApuTCscNsYWrk1EaQGEMK5MTwAtNK5uO4s8XcuqMcU5e3ssO8Xwe0Ga9eDJYt-bEcNCuiqKsk4-6kS-fkAewhLHNJvmUKRWshYbJY6UjYEootNT9IOJa4L0Zl8f9GZfb_Y1KJ3sp9CrU-ml3d7uIyfdCXhzAgxZ07toRuvpnhOCq0pClbj3Rw6TsTuPUZP1OFrsfEQ76y74_8_x4UHc9n70qeMtrkj__qtJaNA_tz3Z1gQaAN4oVfwFRsS4cQ</recordid><startdate>20091201</startdate><enddate>20091201</enddate><creator>van der Lee, I</creator><creator>Gietema, H.A</creator><creator>Zanen, P</creator><creator>van Klaveren, R.J</creator><creator>Prokop, M</creator><creator>Lammers, J.-W.J</creator><creator>van den Bosch, J.M.M</creator><general>Elsevier Ltd</general><general>Elsevier</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>ASE</scope><scope>FPQ</scope><scope>H94</scope><scope>K6X</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20091201</creationdate><title>Nitric oxide diffusing capacity versus spirometry in the early diagnosis of emphysema in smokers</title><author>van der Lee, I ; Gietema, H.A ; Zanen, P ; van Klaveren, R.J ; Prokop, M ; Lammers, J.-W.J ; van den Bosch, J.M.M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c512t-c4b970041dcb34e21aab2fe9ac3fb5125c0022af5e2100b09f8bdce1c00479a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged</topic><topic>Airway management</topic><topic>Biological and medical sciences</topic><topic>Chronic obstructive pulmonary disease, asthma</topic><topic>Confidence intervals</topic><topic>COPD</topic><topic>Diffusion capacity</topic><topic>Emphysema</topic><topic>Epidemiologic Methods</topic><topic>Humans</topic><topic>Hypotheses</topic><topic>Lungs</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Medical screening</topic><topic>Middle Aged</topic><topic>Nitric oxide</topic><topic>Nitric Oxide - metabolism</topic><topic>Pneumology</topic><topic>Pulmonary Diffusing Capacity - methods</topic><topic>Pulmonary Emphysema - diagnosis</topic><topic>Pulmonary Emphysema - physiopathology</topic><topic>Pulmonary/Respiratory</topic><topic>Smoking - adverse effects</topic><topic>Spirometry</topic><topic>Spirometry - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van der Lee, I</creatorcontrib><creatorcontrib>Gietema, H.A</creatorcontrib><creatorcontrib>Zanen, P</creatorcontrib><creatorcontrib>van Klaveren, R.J</creatorcontrib><creatorcontrib>Prokop, M</creatorcontrib><creatorcontrib>Lammers, J.-W.J</creatorcontrib><creatorcontrib>van den Bosch, J.M.M</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van der Lee, I</au><au>Gietema, H.A</au><au>Zanen, P</au><au>van Klaveren, R.J</au><au>Prokop, M</au><au>Lammers, J.-W.J</au><au>van den Bosch, J.M.M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nitric oxide diffusing capacity versus spirometry in the early diagnosis of emphysema in smokers</atitle><jtitle>Respiratory medicine</jtitle><addtitle>Respir Med</addtitle><date>2009-12-01</date><risdate>2009</risdate><volume>103</volume><issue>12</issue><spage>1892</spage><epage>1897</epage><pages>1892-1897</pages><issn>0954-6111</issn><eissn>1532-3064</eissn><abstract>Summary The diffusion capacity for nitric oxide (DLNO) is independent of pulmonary capillary blood volume and equals the membrane diffusing capacity. Therefore the DLNO could be more sensitive in detecting alveolar destruction than the DLCO. We measured flow-volumes curves, DLNO, DLCO, the transfer coefficients KNO (DLNO/VA) and KCO (DLCO/VA) and performed computed tomography (CT) scans in 263 randomly selected heavy smokers. Subjects with areas ≥1% of the total lung volume showing an attenuation <−950 Hounsfield Units were considered to have emphysema. In 36 subjects emphysema was diagnosed with CT, a low KNO was present in 94 subjects, and in 95 subjects a FEV1/FVC ratio <70% was seen. The area under the ROC curve for detection CT-based emphysema was 0.894 for the KNO, 0.822 for the KCO and 0.795 for FEV1/FVC, meaning that the KNO has a slightly higher sensitivity to detect emphysema than the KCO and FEV1/FVC. The positive predictive value of KNO however was low (34.7%), while the negative predictive value of KNO was very high (98.2%), indicating an emphysema exclusion test. The DLNO/DLCO ratio is significantly higher in the study group compared to normal subjects.</abstract><cop>Kidlington</cop><pub>Elsevier Ltd</pub><pmid>19586765</pmid><doi>10.1016/j.rmed.2009.06.005</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Respiratory medicine, 2009-12, Vol.103 (12), p.1892-1897 |
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| source | ScienceDirect Freedom Collection 2022-2024 |
| subjects | Aged Airway management Biological and medical sciences Chronic obstructive pulmonary disease, asthma Confidence intervals COPD Diffusion capacity Emphysema Epidemiologic Methods Humans Hypotheses Lungs Male Medical imaging Medical sciences Medical screening Middle Aged Nitric oxide Nitric Oxide - metabolism Pneumology Pulmonary Diffusing Capacity - methods Pulmonary Emphysema - diagnosis Pulmonary Emphysema - physiopathology Pulmonary/Respiratory Smoking - adverse effects Spirometry Spirometry - methods |
| title | Nitric oxide diffusing capacity versus spirometry in the early diagnosis of emphysema in smokers |
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