UBC Faculty Research and Publications

COPD phenotypes in biomass smoke – versus tobacco smoke-exposed Mexican women Ramirez-Venegas, Alejandra; Sansores, Raul H.; Alva, Luis F; McDougall, Jill E.; Sin, Don D.; Silva, C. Isabela S.; Rojas, Carlos E.; Coxson, Harvey O.; Camp, Pat; Paré, P.D.; Müller, Nestor Luiz, 1948-

Abstract

We hypothesized that biomass smoke exposure is associated with an airway-predominant COPD phenotype, while tobacco-related COPD is associated with an emphysema-predominant phenotype. In this cross-sectional study, female never-smokers with COPD and biomass exposure (n=21) and female ex-cigarette smokers with COPD without biomass exposure (n=22) completed computed tomography (CT) at inspiration and expiration, pulmonary function, blood gas, exercise tolerance, and quality of life measures. Two radiologists scored the extent of emphysema and air trapping on CT. Quantitative emphysema severity and distribution, and airway wall thickness were calculated using specialized software. Women in the tobacco group had significantly more emphysema than the biomass group (radiologist score 2·3 vs 0·7, p=0·001; % emphysema on CT scan 27% vs 19%, p=0·046; and a larger size of emphysematous spaces, p=0·006). Women in the biomass group had significantly more air trapping than the tobacco group (radiologist score = 2·6 and 1·5 respectively; p=0·02) and also scored lower on the symptom, activities and confidence domains of quality of life and had lower oxygen saturation at rest and during exercise (p

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