{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T05:10:07Z","timestamp":1748754607182,"version":"3.41.0"},"reference-count":39,"publisher":"FapUNIFESP (SciELO)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. bras. pneumol."],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:p>ABSTRACT OBJECTIVE: To evaluate the impact that the distribution of emphysema has on clinical and functional severity in patients with COPD. METHODS: The distribution of the emphysema was analyzed in COPD patients, who were classified according to a 5-point visual classification system of lung CT findings. We assessed the influence of emphysema distribution type on the clinical and functional presentation of COPD. We also evaluated hypoxemia after the six-minute walk test (6MWT) and determined the six-minute walk distance (6MWD). RESULTS: Eighty-six patients were included. The mean age was 65.2 \u00b1 12.2 years, 91.9% were male, and all but one were smokers (mean smoking history, 62.7 \u00b1 38.4 pack-years). The emphysema distribution was categorized as obviously upper lung-predominant (type 1), in 36.0% of the patients; slightly upper lung-predominant (type 2), in 25.6%; homogeneous between the upper and lower lung (type 3), in 16.3%; and slightly lower lung-predominant (type 4), in 22.1%. Type 2 emphysema distribution was associated with lower FEV1, FVC, FEV1\/FVC ratio, and DLCO. In comparison with the type 1 patients, the type 4 patients were more likely to have an FEV1 &lt; 65% of the predicted value (OR = 6.91, 95% CI: 1.43-33.45; p = 0.016), a 6MWD &lt; 350 m (OR = 6.36, 95% CI: 1.26-32.18; p = 0.025), and post-6MWT hypoxemia (OR = 32.66, 95% CI: 3.26-326.84; p = 0.003). The type 3 patients had a higher RV\/TLC ratio, although the difference was not significant. CONCLUSIONS: The severity of COPD appears to be greater in type 4 patients, and type 3 patients tend to have greater hyperinflation. The distribution of emphysema could have a major impact on functional parameters and should be considered in the evaluation of COPD patients.<\/jats:p>","DOI":"10.1590\/s1806-37562015000000136","type":"journal-article","created":{"date-parts":[[2016,1,17]],"date-time":"2016-01-17T04:30:18Z","timestamp":1453005018000},"page":"489-495","source":"Crossref","is-referenced-by-count":8,"title":["Influence of emphysema distribution on pulmonary function parameters in COPD patients"],"prefix":"10.1590","volume":"41","author":[{"given":"Helder Novais e","family":"Bastos","sequence":"first","affiliation":[{"name":"Centro Hospitalar de S\u00e3o Jo\u00e3o EPE, Portugal; Universidade do Minho, Portugal; Instituto de Investiga\u00e7\u00e3o em Ci\u00eancias da Vida e Sa\u00fade, Portugal"}]},{"given":"In\u00eas","family":"Neves","sequence":"additional","affiliation":[{"name":"Centro Hospitalar de S\u00e3o Jo\u00e3o EPE, Portugal"}]},{"given":"Margarida","family":"Redondo","sequence":"additional","affiliation":[{"name":"Centro Hospitalar de S\u00e3o Jo\u00e3o EPE, Portugal"}]},{"given":"Rui","family":"Cunha","sequence":"additional","affiliation":[{"name":"Centro Hospitalar de S\u00e3o Jo\u00e3o EPE, Portugal; Universidade do Porto, Portugal"}]},{"given":"Jos\u00e9 Miguel","family":"Pereira","sequence":"additional","affiliation":[{"name":"Centro Hospitalar de S\u00e3o Jo\u00e3o EPE, Portugal; Universidade do Porto, Portugal"}]},{"given":"Adriana","family":"Magalh\u00e3es","sequence":"additional","affiliation":[{"name":"Centro Hospitalar de S\u00e3o Jo\u00e3o EPE, Portugal"}]},{"given":"Gabriela","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Centro Hospitalar de S\u00e3o Jo\u00e3o EPE, Portugal; Universidade do Porto, Portugal"}]}],"member":"530","reference":[{"year":"2011","series-title":"Global Strategy for the Diagnosis, Management and Prevention of COPD--revised","key":"ref1"},{"issue":"1","key":"ref2","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1378\/chest.10-0984","article-title":"Emphysema presence, severity, and distribution has little impact on the clinical presentation of a cohort of patients with mild to moderate COPD","volume":"139","author":"de Torres JP","year":"2011","journal-title":"Chest"},{"issue":"6","key":"ref3","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1513\/pats.200603-029MS","article-title":"Mitchell lecture. 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Correlation of computed tomography and pathology scores","volume":"141","author":"Kuwano K","year":"1990","journal-title":"Am Rev Respir Dis"},{"issue":"4","key":"ref39","doi-asserted-by":"crossref","first-page":"791","DOI":"10.2214\/ajr.162.4.8140992","article-title":"CT of the lung in patients with pulmonary emphysema: diagnosis, quantification, and correlation with pathologic and physiologic findings","volume":"162","author":"Stern EJ","year":"1994","journal-title":"AJR Am J Roentgenol"}],"container-title":["Jornal Brasileiro de Pneumologia"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/jbpneu\/v41n6\/1806-3713-jbpneu-41-06-00489.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T04:37:32Z","timestamp":1748752652000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S1806-37132015000600489&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12]]},"references-count":39,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2015,12]]}},"alternative-id":["S1806-37132015000600489"],"URL":"https:\/\/doi.org\/10.1590\/s1806-37562015000000136","relation":{},"ISSN":["1806-3713"],"issn-type":[{"type":"electronic","value":"1806-3713"}],"subject":[],"published":{"date-parts":[[2015,12]]}}}