6533b854fe1ef96bd12ade40

RESEARCH PRODUCT

Small airway disease (SAD) is associated with respiratory symptoms and relevant for therapy in early COPD

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description

Background: SAD is common in patients with COPD. Occurring early in the course of the disease, it is frequently missed by currently used diagnostic tests. Multiple breath washout (MBW) testing detects ventilation heterogeneity (VH) while oscillometry (OS) assesses peripheral obstruction, both associated with SAD. We therefore set out to evaluate the presence and symptoms of SAD in patients with early COPD. Methods: We prospectively evaluated 26 patients (FEV1 77±19% pred., 88% GOLD I/II). In an 8-week cross-over design, the effect of dual bronchodilatation (tiotropium/olodaterol, T/O) on lung function and symptoms (CAT) was compared to monotherapy (formoterol). Lung function was assessed by spirometry, OS and SF6-MBW. Results: Patients with a high CAT dyspnoea item (≥3) had increased frequency dependence of resistance (D5-20, p Conclusions: SAD is present even in early COPD stages and associated with respiratory symptoms. These can be addressed with dual bronchodilatation exceeding the effect of monotherapy.