Distribution of emphysema in heavy smokers: impact on pulmonary function.
Publication year
2010Source
Respiratory Medicine, 104, 1, (2010), pp. 76-82ISSN
Annotation
01 januari 2010
Publication type
Article / Letter to editor
![https://hdl.handle.net/2066/88840](https://cdn.statically.io/img/repository.ubn.ru.nl/themes/Mirage2//images/copy.png)
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Organization
Radiology
Journal title
Respiratory Medicine
Volume
vol. 104
Issue
iss. 1
Page start
p. 76
Page end
p. 82
Subject
N4i 4: Auto-immunity, transplantation and immunotherapy; Medical Imaging - Radboud University Medical CenterAbstract
PURPOSE: To investigate impact of distribution of computed tomography (CT) emphysema on severity of airflow limitation and gas exchange impairment in current and former heavy smokers participating in a lung cancer screening trial. MATERIALS AND METHODS: In total 875 current and former heavy smokers underwent baseline low-dose CT (30 mAs) in our center and spirometry and diffusion capacity testing on the same day as part of the Dutch-Belgian Lung Cancer Screening Trial (NELSON). Emphysema was quantified for 872 subjects as the number of voxels with an apparent lowered X-ray attenuation coefficient. Voxels attenuated <-950 HU were categorized as representing severe emphysema (ES950), while voxels attenuated between -910 HU and -950 HU represented moderate emphysema (ES910). Impact of distribution on severity of pulmonary function impairment was investigated with logistic regression, adjusted for total amount of emphysema. RESULTS: For ES910 an apical distribution was associated with more airflow obstruction and gas exchange impairment than a basal distribution (both p<0.01). The FEV(1)/FVC ratio was 1.6% (95% CI 0.42% to 2.8%) lower for apical predominance than for basal predominance, for Tlco/V(A) the difference was 0.12% (95% CI 0.076-0.15%). Distribution of ES950 had no impact on FEV(1)/FVC ratio, while an apical distribution was associated with a 0.076% (95% CI 0.038-0.11%) lower Tlco/V(A) (p<0.001). CONCLUSION: In a heavy smoking population, an apical distribution is associated with more severe gas exchange impairment than a basal distribution; for moderate emphysema it is also associated with a lower FEV(1)/FVC ratio. However, differences are small, and likely clinically irrelevant.
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- Faculty of Medical Sciences [91954]
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