{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T03:14:13Z","timestamp":1790651653348,"version":"4.1.0"},"reference-count":39,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2016,11,17]],"date-time":"2016-11-17T00:00:00Z","timestamp":1479340800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2016,11,17]],"date-time":"2016-11-17T00:00:00Z","timestamp":1479340800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respiration"],"published-print":{"date-parts":[[2017]]},"abstract":"<b><i>Background:<\/i><\/b> In chronic obstructive pulmonary disease (COPD) patients, small-airway dysfunction (SAD) is considered a functional hallmark of disease. However, the exact role of SAD in the clinical presentation of COPD is not yet completely understood; moreover, it is not known whether SAD may have a relationship with the impact of disease. <b><i>Objectives:<\/i><\/b> To evaluate the prevalence of SAD among COPD patients categorized by the old and the new GOLD classification and to ascertain whether there is a relationship between SAD and impact of disease measured by the COPD Assessment Test (CAT) questionnaire. <b><i>Methods:<\/i><\/b> We prospectively enrolled COPD outpatients from the University Hospital of Parma. Using the impulse oscillometry system (IOS), we assessed the fall in resistance from 5 to 20 Hz (R5-R20), reactance at 5 Hz (X5), and resonant frequency (<i>F<\/i><sub>Res<\/sub>) as markers of peripheral airway dysfunction. According to R5-R20 \u22650.07 or <0.07, the cohort was also categorized in patients with and without SAD, respectively. <b><i>Results:<\/i><\/b> We studied 202 patients. In both GOLD classifications, a progressive increasing distribution of R5-R20 and <i>F<\/i><sub>Res<\/sub> was reported with a decreasing of X5. Moreover, there was a significant correlation between R5-R20 and CAT (<i>r<\/i> = 0.527, <i>p<\/i> < 0.001). Finally, the presence of SAD (OR 11.96; 95% CI 4.53-31.58; <i>p<\/i> < 0.001) and use of ICS + LABA + LAMA (OR 5.31; 95% CI 1.88-15.02; <i>p<\/i> = 0.002) were independent predictors of higher impact (CAT score \u226510). <b><i>Conclusion:<\/i><\/b> In COPD patients, the presence of SAD, as assessed by IOS, progressively increases with GOLD classifications and it is closely related to the high impact of disease on health status.<\/jats:p>","DOI":"10.1159\/000452479","type":"journal-article","created":{"date-parts":[[2016,11,16]],"date-time":"2016-11-16T22:57:34Z","timestamp":1479337054000},"page":"32-41","source":"Crossref","is-referenced-by-count":104,"title":["Prevalence of Small-Airway Dysfunction among COPD Patients with Different GOLD Stages and Its Role in the Impact of Disease"],"prefix":"10.1159","volume":"93","author":[{"given":"Ernesto","family":"Crisafulli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Pisi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Aiello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Vigna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiota","family":"Tzani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Torres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppina","family":"Bertorelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Chetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2016,11,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200703-456SO"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60693-6"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201204-0596PP"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00010410"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032158"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200612-1772OC"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2466-10-10"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0b013e32835ceefc"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1378\/chest.73.5.568"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.01.00046401"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2012.04.010"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S82509"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2011.01.010"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2004.02261.x"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00035205"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.03.00089403"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-0913"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.309.6948.188"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-010-9275-y"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(14)70103-1"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00082314"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.3109\/15412555.2010.510161"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2013.10.004"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1586\/17476348.2016.1161508"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S23746"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.2147\/PROM.S55276"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2014.07.008"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1177\/2050312115578957"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16900-6"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2013-203270"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.3109\/15412555.2010.497515"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00195212"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00177210"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00025214"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-2449"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1378\/chest.15-1752"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.3109\/15412555.2011.630248"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.3109\/15412551003631691"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(14)70266-8"}],"container-title":["Respiration"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/452479","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/452479","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/452479","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T17:22:01Z","timestamp":1745428921000},"score":1,"resource":{"prima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