[Chronic obstructive pulmonary disorder (COPD) patients with the syndrome of combined pulmonary fibrosis and emphysema, compared to patients with emphysema alone].

BACKGROUND: In recent years the syndrome of combined puLmonary fibrosis and emphysema (CPFE) was recognized as a unique disorder. The diagnosis of CPFE is based on the pulmonary findings of High ResoLution Computed Tomography (HRCT) of the Lung. Patients with this entity have reLativeLy preserved lung volumes and spirometry but marked reductions in diffusing capacity on pulmonary function testing. OBJECTIVES: Since dyspnea is the main symptom that limits daily activities in patients with COPD, we wanted to compare the clinical features, exercise tolerance, quality of life and dyspnea of patient with CPFE to patients with emphysema alone. METHODS: A total of 14 patients with CPFE were compared to 16 patients with COPD and emphysema alone. All patients had HRCT, spirometery, body ptethysmography, CO diffusion capacity, 6 minute walk test, inspiratory muscle strength, measurements of the perception of dyspnea at rest and following effort, and they completed a questionnaire on quality of Life aspects. RESULTS: Patients with CPFE were a littLe younger, had a similar smoking history, had milder airway obstruction, smaller RV and FRC, and more severe reductions in diffusing capacity. They had more dyspnea at rest and following effort, and their exercise tolerance and quality of life were significantly reduced compared to patients with emphysema alone. CONCLUSIONS: The group of patients with combined pulmonary fibrosis and emphysema (CPFE), based on the HRCT, is characterized by relatively preserved lung volumes and spirometry but marked reductions in diffusing capacity, exercise tolerance, quality of life and higher perception of dyspnea, compared to patients with emphysema alone.