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* From the Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA.
Correspondence to: Frank C. Sciurba, MD, FCCP, Associate Professor of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, 1211 Kaufmann Bldg, Pittsburgh, PA 15213; e-mail: sciurbafc{at}upmc.edu
The structural and physiologic findings in asthma and COPD appear, on average, and in the extremes of presentation, to be easily distinguished. A closer inspection of the literature reveals that significant overlap exists in individual patients with respect to airway wall thickening and low-attenuation parenchymal regions on CT scans, and in reversibility, airway hyperresponsiveness, lung diffusion, resting and dynamic hyperinflation, lung elastic recoil, exercise response, and a "pharmaceutical volume reduction" effect following therapy with bronchodilators. In particular, the subgroup of COPD patients having an airway-dominant phenotype becomes indistinguishable from asthmatic subjects with reversible disease that evolves into an incompletely reversible pattern.
Key Words: asthma COPD emphysema exercise hyperinflation lung elastic recoil
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