ABSTRACT

Objective: It was aimed to investigate whether there was a change in the pulmonary stiffness (PS) value detected by pulmonary elastography (PE) in patients with chronic obstructive pulmonary disease (COPD) and heart failure (HF) and to evaluate the utility of the PS value in the differential diagnosis of these diseases.

Material and Methods: The study included 20-healthy controls (Group-I) and 50-COPD (Group-II) and 50-HF patients (Group-III). In addition to routine examinations, PS of the patients was measured with PE.

Results: PS value was found to be significantly different between all groups, and Group II had the highest PS value (p< 0.05). PS values in Groups I-II-III were measured as 10.2 ± 1.4 kPa-29.1 ± 6.8 kPa-15.7 ± 3.8 kPa, respectively. It was also found that the PS value independently determined the presence of COPD (p< 0.001). According to this analysis, it was found that every 1 kPa rise increased the risk of having COPD by 85%. When 20 kPa was taken as the limit value in ROC curve analysis, it determined the patients with COPD with 96% sensitivity and 92.3% specificity. In addition, the measured PS values in COPD GOLD stages II-III-IV increased with the severity of the disease and found to be 25.5 ± 4.64 kPa, 29.5 ± 5.96 kPa, and 33.3 ± 9.85 kPa, respectively (p< 0.001).

Conclusion: In COPD and HF patients, more prominent in patients with COPD, the PS measured with PE increased. This PS elevation in COPD may be a novel differential diagnostic method in the differentiation of COPD patients from HF patients. In particular, the PS>20 kPa can be used as a limit value for the differential diagnosis for COPD.

Keywords: Chronic obstructive pulmonary disease, heart failure, pulmonary elastography, pulmonary stiffness