Lung Hyperinflation as Treatable Trait in Chronic Obstructive Pulmonary Disease: A Narrative Review

Abstract

Maud Koopman,1– 3 Rein Posthuma,1– 3 Lowie EGW Vanfleteren,4 Sami O Simons,2,3 Frits ME Franssen1– 3 1Research and Development, Ciro+, Horn, the Netherlands; 2NUTRIM, Institute of Nutrition and Translational Research in Metabolism, University Maastricht, Maastricht, the Netherlands; 3Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; 4COPD Center, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, SwedenCorrespondence: Frits ME Franssen, CIRO+, Hornerheide 1, Horn, 6085, NM, the Netherlands, Email [email protected]: Lung hyperinflation (LH) is a common clinical feature in patients with chronic obstructive pulmonary disease (COPD). It results from a combination of reduced elastic lung recoil as a consequence of irreversible destruction of lung parenchyma and expiratory airflow limitation. LH is an important determinant of morbidity and mortality in COPD, partially independent of the degree of airflow limitation. Therefore, reducing LH has become a major target in the treatment of COPD over the last decades. Advances were made in the diagnostics of LH and several effective interventions became available. Moreover, there is increasing evidence suggesting that LH is not only an isolated feature in COPD but rather part of a distinct clinical phenotype that may require a more integrated management. This narrative review focuses on the pathophysiology and adverse consequences of LH, the assessment of LH with lung function measurements and imaging techniques and highlights LH as a treatable trait in COPD. Finally, several suggestions regarding future studies in this field are made.Keywords: COPD, hyperinflation, treatable trait, emphysema, phenotype

Keywords

• copd
• hyperinflation
• treatable trait
• emphysema
• phenotype