Diagnostic and Therapeutic Approaches to Hyperinflation and Small Airway Disease in COPD
Diagnostic and Therapeutic Approaches to Hyperinflation and Small Airway Disease in COPD
Current guideline-based criteria defining COPD do not meet the challenges set by the complex
 pathophysiology of the disease. Hyperinflation and affection of the small airways are two
 components that are not represented in current diagnostic concepts and may relate to early
 stages of the disease. Moreover, optimal therapeutic interventions in patients with these
 distinct features remain unclear. The investigators therefore aimed to evaluate novel or not
 widely used diagnostic approaches for the detection and initiating therapeutic strategies in
 early stage COPD within the GOLD recommendations.
Inclusion Criteria:

 -  known or first diagnosis of COPD

 -  lung function testing consistent with hyperinflation or peripheral obstruction

 -  emphysema in imaging

 -  symptoms (dyspnea, cough, sputum) and risk factors (>= 10 pack years)

 -  indication for bronchodilator therapy

 Exclusion Criteria:

 -  GOLD stages 3 and 4 (spirometric)

 -  indication for dual bronchodilator therapy, triple therapy or inhaled steroid

 -  contraindication for cardiopulmonary exercise testing

 -  unwilling to participate