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Am J Respir Crit Care Med. 2007 Aug 1;176(3):243-52. Epub 2007 Apr 12.

Sex differences in severe pulmonary emphysema.

Collaborators (447)

Fishman AP, Bozzarello BA, Al-Amin A, Katz M, Wheeler C, Baker E, Barnard P, Cagle P, Carter J, Chatziioannou S, Conejo-Gonzales K, Dubose K, Haddad J, Hicks D, Kleiman N, Milburn-Barnes M, Nguyen C, Reardon M, Reeves-Viets J, Sax S, Sharafkhaneh A, Wilson O, Young C, Espada R, Butanda R, Ellisor M, Fox P, Hale K, Hood E, Jahn A, Jhingran S, King K, Miller C 3rd, Nizami I, Officer T, Ricketts J, Rodarte J, Teague R, Williams K, Reilly J, Sugarbaker D, Fanning C, Body S, Duffy S, Formanek V, Fuhlbrigge A, Hartigan P, Hooper S, Hunsaker A, Jacobson F, Moy M, Peterson S, Russell R, Saunders D, Swanson S, McKenna R, Mohsenifar Z, Geaga C, Biring M, Clark S, Cutler J, Frantz R, Julien P, Lewis M, Minkoff-Rau J, Yegyan V, Joyner M, DeCamp M, Stoller J, Meli Y, Apostolakis J, Atwell D, Chapman J, DeVilliers P, Dweik R, Kraenzler E, Lann R, Kurokawa N, Marlow S, McCarthy K, McCreight P, Mehta A, Meziane M, Minai O, Steiger M, White K, Maurer J, Durr T, Hearn C, Lubell S, O'Donovan P, Schilz R, Ginsburg M, Thomashow B, Jellen P, Austin J, Bartels M, Berkman Y, Berkoski P, Brogan F, Chong A, DeMercado G, DiMango A, Do S, Kachulis B, Khan A, Mets B, O'Shea M, Pearson G, Rossoff L, Scharf S, Shiau M, Simonelli P, Stavrolakes K, Tsang D, Vilotijevic D, Yip C, Mantinaos M, McKeon K, Pfeffer J, MacIntyre N, Davis RD, Howe J, Coleman RE, Crouch R, Greene D, Grichnik K, Harpole D Jr, Krichman A, Lawlor B, McAdams H, Plankeel J, Rinaldo-Gallo S, Shearer S, Smith J, Stafford-Smith M, Tapson V, Steele M, Norten J, Utz J, Deschamps C, Mieras K, Abel M, Allen M, Andrist D, Aughenbaugh G, Bendel S, Edell E, Edgar M, Edwards B, Elliot B, Garrett J, Gillespie D, Gurney J, Hammel B, Hanson K, Hanson L, Harms G, Hart J, Hartman T, Hyatt R, Jensen E, Kalra S, Karsell P, Lamb J, Midthun D, Mottran C, Swensen S, Sykes AM, Taylor K, Torres N, Hubmayr R, Miller D, Bartling S, Bradt K, Make B, Pomerantz M, Gilmartin M, Canterbury J, Martin C, Dibbern P, Fernandez E, Geyman L, Hudson C, Lynch D, Newell J, Quaife R, Propst J, Raymond C, Whalen-Price J, Winner K, Zamora M, Cherniack R, Diaz P, Ross P, Bees T, Drake J, Emery C, Gerhardt M, King M, Rittinger D, Rittinger M, Naunheim K, Gerber R, Osterloh J, Borosh S, Chamberlain W, Frese S, Hibbit A, Kleinhenz ME, Ruppel G, Stolar C, Willey J, Alvarez F, Keller C, Criner G, Furukawa S, Kuzma AM, Barnette R, Brister N, Carney K, Chatila W, Cordova F, D'Alonzo G, Keresztury M, Kirsch K, Kwak C, Lautensack K, Lorenzon M, Martin U, Rising P, Schartel S, Travaline J, Vance G, Boiselle P, O'Brien G, Ries A, Kaplan R, Ramirez C, Frankville D, Friedman P, Harrell J, Johnson J, Kapelanski D, Kupferberg D, Larsen C, Limberg T, Magliocca M, Papatheofanis FJ, Sassi-Dambron D, Weeks M, Krasna M, Fessler H, Gilbert T, Orens J, Scharf S, Shade D, Siegelman S, Silver K, Weir C, White C, Martinez F, Iannettoni M, Meldrum C, Bria W, Campbell K, Christensen P, Flaherty K, Gay S, Gill P, Kazanjian P, Kazerooni E, Knieper V, Ojo T, Poole L, Quint L, Rysso P, Sisson T, True M, Woodcock B, Zaremba L, Kaiser L, Hansen-Flaschen J, Dempsey ML, Alavi A, Alcorn T, Arcasoy S, Aronchick J, Aukberg S, Benedict B, Craemer S, Daniele R, Edelman J, Gefter W, Kotler-Klein L, Kotloff R, Lipson D, Miller W Jr, O'Connell R, Opelman S, Palevsky H, Russell W, Sheaffer H, Simcox R, Snedeker S, Stone-Wynne J, Tino G, Wahl P, Walter J, Ward P, Zisman D, Mendez J, Wurster A, Sciurba F, Luketich J, Witt C, Ayres G, Donahoe M, Fuhrman C, Hoffman R, Lacomis J, Sexton J, Slivka W, Strollo D, Sullivan E, Simon T, Wrona C, Bauldoff G, Brown M, George E, Keenan R, Kopp T, Silfies L, Benditt J, Wood D, Snyder M, Anable K, Battaglia N, Boitano L, Bowdle A, Chan L, Chwalik C, Culver B, Gillespy T, Godwin D, Hoffman J, Ibrahim A, Lockhart D, Marglin S, Martay K, McDowell P, Oxorn D, Roessler L, Toshima M, Golden S, Bosco L, Chiang YP, Clancy C, Handelsman H, Berkowitz SM, Carino T, Chin J, Baldwin J, McVearry K, Norris A, Shirey S, Sikora C, Sheingold S, Piantadosi S, Tonascia J, Belt P, Blackford A, Collins K, Collison B, Colvin R, Dodge J, Donithan M, Edmonds V, Foster GL, Fuller J, Harle J, Jackson R, Lee S, Levine C, Livingston H, Meinert J, Meyers J, Nowakowski D, Owens K, Qi S, Smith M, Simon B, Smith P, Sternberg A, Van Natta M, Wilson L, Wise R, Kaplan RM, Schwartz JS, Chiang YP, Fahs MC, Fendrick AM, Moskowitz AJ, Pathak D, Ramsey S, Sheingold S, Shroyer AL, Wagner J, Yusen R, Ramsey S, Etzioni R, Sullivan S, Wood D, Schroeder T, Kreizenbeck K, Berry K, Howlader N, Hoffman E, Cook-Granroth J, Delsing A, Guo J, McLennan G, Mullan B, Piker C, Reinhardt J, Robinswood B, Sieren J, Stanford W, Waldhausen JA, Bernard G, DeMets D, Ferguson M, Hoover E, Levine R, Mahler D, McSweeny AJ, Wiener-Kronish J, Williams OD, Younes M, Criner G, Soltoff C, Weinmann G, Deshler J, Follmann D, Kiley J, Wu M, Gelb A.

Author information

1
University of Michigan, Division of Pulmonary and Critical Care Medicine, Ann Arbor, Michigan 48109-0360, USA. Fmartine@umich.edu

Abstract

RATIONALE:

Limited data on sex differences in advanced COPD are available.

OBJECTIVES:

To compare male and female emphysema patients with severe disease.

METHODS:

One thousand fifty-three patients (38.8% female) evaluated for lung volume reduction surgery as part of the National Emphysema Treatment Trial were analyzed.

MEASUREMENTS AND MAIN RESULTS:

Detailed clinical, physiological, and radiological assessment, including quantitation of emphysema severity and distribution from helical chest computed tomography, was completed. In a subgroup (n = 101), airway size and thickness was determined by histological analyses of resected tissue. Women were younger and exhibited a lower body mass index (BMI), shorter smoking history, less severe airflow obstruction, lower Dl(co) and arterial Po(2), higher arterial Pco(2), shorter six-minute walk distance, and lower maximal wattage during oxygen-supplemented cycle ergometry. For a given FEV(1)% predicted, age, number of pack-years, and proportion of emphysema, women experienced greater dyspnea, higher modified BODE, more depression, lower SF-36 mental component score, and lower quality of well-being. Overall emphysema was less severe in women, with the difference from men most evident in the outer peel of the lung. Females had thicker small airway walls relative to luminal perimeters.

CONCLUSIONS:

In patients with severe COPD, women, relative to men, exhibit anatomically smaller airway lumens with disproportionately thicker airway walls, and emphysema that is less extensive and characterized by smaller hole size and less peripheral involvement.

PMID:
17431226
PMCID:
PMC1994221
DOI:
10.1164/rccm.200606-828OC
[Indexed for MEDLINE]
Free PMC Article

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