Computed tomography structural lung changes in discordant airflow limitation
- PMID: 23785411
- PMCID: PMC3681780
- DOI: 10.1371/journal.pone.0065177
Computed tomography structural lung changes in discordant airflow limitation
Abstract
Background: There is increasing evidence that structural lung changes may be present before the occurrence of airflow limitation as assessed by spirometry. This study investigated the prevalence of computed tomography (CT) quantified emphysema, airway wall thickening and gas trapping according to classification of airflow limitation (FEV1/FVC <70% and/or < the lower limit of normal (LLN)) in (heavy) smokers.
Methods: A total number of 1,140 male former and current smokers participating in a lung cancer screenings trial (NELSON) were included and underwent chest CT scanning and spirometry. Emphysema was quantified by the 15(th) percentile, air way wall thickening by the square root of wall area for a theoretical airway with 10mm lumen perimeter (Pi10) and gas trapping by the mean lung density expiratory/inspiratory (E/I)-ratio. Participants were classified by entry FEV1/FVC: group 1>70%; group 2<70% but >LLN; and group 3<LLN. 32 restricted subjects, i.e. FEV1/FVC >70% but FEV1 <80% predicted, were excluded. Multivariate regression analysis correcting for covariates was used to asses the extent of emphysema, airway wall thickening and gas trapping according to three groups of airflow limitation.
Results: Mean (standard deviation) age was 62.5 (5.2) years and packyears smoked was 41.0 (18.0). Group 2 subjects when compared to group 1 had a significantly lower 15(th) percentile, -920.6 HU versus -912.2 HU; a higher Pi10, 2.87 mm versus 2.57 mm; and a higher E/I-ratio, 88.6% versus 85.6% (all p<0.001).
Conclusion: Subjects with an FEV1/FVC<70%, but above the LLN, have a significant greater degree of structural lung changes on CT compared to subjects without airflow limitation.
Conflict of interest statement
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References
-
- Mannino DM, Buist AS (2007) Global burden of COPD: risk factors, prevalence, and future trends. Lancet 370(9589): 765–73. - PubMed
-
- Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, et al... (2012) Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease, GOLD Executive Summary. Am J Respir Crit Care Med Epub ahead of print. doi: 10.1164/rccm.201204–0596. - PubMed
-
- Hogg JC (2004) Pathophysiology of airflow limitation in chronic obstructive pulmonary disease. Lancet 364(9435): 709–21. - PubMed
-
- Hackx M, Bankier AA, Gevenois PA (2012) Chronic Obstructive Pulmonary Disease: CT Quantification of Airways Disease. Radiology 265(1): 34–48. - PubMed
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