Abstract
Background: CT scan measures of emphysema and airway disease have been correlated with lung function in cohorts of subjects with a range of COPD severity. The contribution of CT scan-assessed airway disease to objective measures of lung function and respiratory symptoms such as dyspnea in severe emphysema is less clear. Methods: Using data from 338 subjects in the National Emphysema Treatment Trial (NETT) Genetics Ancillary Study, densitometric measures of emphysema using a threshold of -950 Hounsfield units (%LAA-950) and airway wall phenotypes of the wall thickness (WT) and the square root of wall area (SRWA) of a 10-mm luminal perimeter airway were calculated for each subject. Linear regression analysis was performed for outcome variables FEV 1 and percent predicted value of FEV1 with CT scan measures of emphysema and airway disease. Results: In univariate analysis, there were significant negative correlations between %LAA-950 and both the WT (r = -0.28, p = 0.0001) and SRWA (r = -0.19, p = 0.0008). Airway wall thickness was weakly but significantly correlated with postbronchodilator FEV1% predicted (R = -0.12, p = 0.02). Multivariate analysis showed significant associations between either WT or SRWA (β = -5.2, p = 0.009; β = -2.6, p = 0.008, respectively) and %LAA-950 (β = -10.6, p = 0.03) with the postbronchodilator FEV1% predicted. Male subjects exhibited significantly thicker airway wall phenotypes (p = 0.007 for WT and p = 0.0006 for SRWA). Conclusions: Airway disease and emphysema detected by CT scanning are inversely related in patients with severe COPD. Airway wall phenotypes were influenced by gender and associated with lung function in subjects with severe emphysema.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 396-404 |
| Number of pages | 9 |
| Journal | CHEST |
| Volume | 136 |
| Issue number | 2 |
| DOIs | |
| State | Published - Aug 1 2009 |
| Externally published | Yes |
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
- Cardiology and Cardiovascular Medicine
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In: CHEST, Vol. 136, No. 2, 01.08.2009, p. 396-404.
Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - CT metrics of airway disease and emphysema in severe COPD
AU - Kim, Woo Jin
AU - Silverman, Edwin K.
AU - Hoffman, Eric
AU - Criner, Gerard J.
AU - Mosenifar, Zab
AU - Sciurba, Frank C.
AU - Make, Barry J.
AU - Carey, Vincent
AU - San José Estépar, Raúl
AU - Diaz, Alejandro
AU - Reilly, John J.
AU - Martinez, Fernando J.
AU - Washko, George R.
AU - Fishman, Alfred P.
AU - Bozzarello, Betsy Ann
AU - Al-Amin, Ameena
AU - Katz, Marcia
AU - Wheeler, Carolyn
AU - Baker, Elaine
AU - Barnard, Peter
AU - Cagle, Phil
AU - Carter, James
AU - Chatziioannou, Sophia
AU - Conejo-Gonzales, Karla
AU - Dubose, Kimberly
AU - Haddad, John
AU - Hicks, David
AU - Kleiman, Neal
AU - Milburn-Barnes, Mary
AU - Nguyen, Chinh
AU - Reardon, Michael
AU - Reeves-Viets, Joseph
AU - Sax, Steven
AU - Sharafkhaneh, Amir
AU - Wilson, Owen
AU - Young, Christine
AU - Espada, Rafael
AU - Butanda, Rose
AU - Ellisor, Minnie
AU - Fox, Pamela
AU - Hale, Katherine
AU - Hood, Everett
AU - Jahn, Amy
AU - Jhingran, Satish
AU - King, Karen
AU - Miller, Charles
AU - Nizami, Imran
AU - Officer, Todd
AU - Ricketts, Jeannie
AU - Rodarte, Joe
AU - Teague, Robert
AU - Williams, Kedren
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AU - Sugarbaker, David
AU - Fanning, Carol
AU - Body, Simon
AU - Duffy, Sabine
AU - Formanek, Vladmir
AU - Fuhlbrigge, Anne
AU - Hartigan, Philip
AU - Hooper, Sarah
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AU - Jacobson, Francine
AU - Moy, Marilyn
AU - Peterson, Susan
AU - Russell, Roger
AU - Saunders, Diane
AU - Swanson, Scott
AU - McKenna, Rob
AU - Mohsenifar, Zab
AU - Geaga, Carol
AU - Biring, Manmohan
AU - Clark, Susan
AU - Cutler, Jennifer
AU - Frantz, Robert
AU - Julien, Peter
AU - Lewis, Michael
AU - Minkoff-Rau, Jennifer
AU - Yegyan, Valentina
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AU - De-Camp, Malcolm
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AU - Apostolakis, John
AU - Atwell, Darryl
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AU - Sternberg, Alice
AU - Van Natta, Mark
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AU - Wise, Robert
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AU - Schwartz, J. Sanford
AU - Fahs, Marianne C.
AU - Fendrick, A. Mark
AU - Moskowitz, Alan J.
AU - Pathak, Dev
AU - Ramsey, Scott
AU - Shroyer, A. Laurie
AU - Wagner, Judith
AU - Yusen, Roger
AU - Etzioni, Ruth
AU - Sullivan, Sean
AU - Schroeder, Thomas
AU - Kreizenbeck, Karma
AU - Berry, Kristin
AU - Howlader, Nadia
AU - Cook-Granroth, Janice
AU - Delsing, Angela
AU - Guo, Junfeng
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AU - Wood, Blake
AU - Sieren, Jered
AU - Stanford, William
AU - Waldhausen, John A.
AU - Bernard, Gordon
AU - DeMets, David
AU - Ferguson, Mark
AU - Hoover, Eddie
AU - Levine, Robert
AU - Mahler, Donald
AU - McSweeny, A. John
AU - Wiener-Kronish, Jeanine
AU - Williams, Dale
AU - Younes, Magdy
AU - Soltoff, Charles
AU - Weinmann, Gail
AU - Deshler, Joanne
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AU - Wu, Margaret
N1 - Funding Information: Funding/Support: This research was funded by National Institutes of Health [grant No. 1K23HL089353-01A1] and a grant from the Parker B. Francis Foundation. The NETT is supported by contracts with the National Heart, Lung, and Blood Institute [grants No. N01HR76101, N01HR76102, N01HR76103, N01HR76104, N01HR76105, N01HR76106, N01HR76107, N01HR76108, N01HR76109, N01HR76110, N01HR76111, N01HR76112, N01HR76113, N01HR76114, N01HR76115, N01HR76116, N01HR76118, and N01HR76119], the Centers for Medicare and Medicaid Services, and the Agency for Healthcare Research and Quality.
PY - 2009/8/1
Y1 - 2009/8/1
N2 - Background: CT scan measures of emphysema and airway disease have been correlated with lung function in cohorts of subjects with a range of COPD severity. The contribution of CT scan-assessed airway disease to objective measures of lung function and respiratory symptoms such as dyspnea in severe emphysema is less clear. Methods: Using data from 338 subjects in the National Emphysema Treatment Trial (NETT) Genetics Ancillary Study, densitometric measures of emphysema using a threshold of -950 Hounsfield units (%LAA-950) and airway wall phenotypes of the wall thickness (WT) and the square root of wall area (SRWA) of a 10-mm luminal perimeter airway were calculated for each subject. Linear regression analysis was performed for outcome variables FEV 1 and percent predicted value of FEV1 with CT scan measures of emphysema and airway disease. Results: In univariate analysis, there were significant negative correlations between %LAA-950 and both the WT (r = -0.28, p = 0.0001) and SRWA (r = -0.19, p = 0.0008). Airway wall thickness was weakly but significantly correlated with postbronchodilator FEV1% predicted (R = -0.12, p = 0.02). Multivariate analysis showed significant associations between either WT or SRWA (β = -5.2, p = 0.009; β = -2.6, p = 0.008, respectively) and %LAA-950 (β = -10.6, p = 0.03) with the postbronchodilator FEV1% predicted. Male subjects exhibited significantly thicker airway wall phenotypes (p = 0.007 for WT and p = 0.0006 for SRWA). Conclusions: Airway disease and emphysema detected by CT scanning are inversely related in patients with severe COPD. Airway wall phenotypes were influenced by gender and associated with lung function in subjects with severe emphysema.
AB - Background: CT scan measures of emphysema and airway disease have been correlated with lung function in cohorts of subjects with a range of COPD severity. The contribution of CT scan-assessed airway disease to objective measures of lung function and respiratory symptoms such as dyspnea in severe emphysema is less clear. Methods: Using data from 338 subjects in the National Emphysema Treatment Trial (NETT) Genetics Ancillary Study, densitometric measures of emphysema using a threshold of -950 Hounsfield units (%LAA-950) and airway wall phenotypes of the wall thickness (WT) and the square root of wall area (SRWA) of a 10-mm luminal perimeter airway were calculated for each subject. Linear regression analysis was performed for outcome variables FEV 1 and percent predicted value of FEV1 with CT scan measures of emphysema and airway disease. Results: In univariate analysis, there were significant negative correlations between %LAA-950 and both the WT (r = -0.28, p = 0.0001) and SRWA (r = -0.19, p = 0.0008). Airway wall thickness was weakly but significantly correlated with postbronchodilator FEV1% predicted (R = -0.12, p = 0.02). Multivariate analysis showed significant associations between either WT or SRWA (β = -5.2, p = 0.009; β = -2.6, p = 0.008, respectively) and %LAA-950 (β = -10.6, p = 0.03) with the postbronchodilator FEV1% predicted. Male subjects exhibited significantly thicker airway wall phenotypes (p = 0.007 for WT and p = 0.0006 for SRWA). Conclusions: Airway disease and emphysema detected by CT scanning are inversely related in patients with severe COPD. Airway wall phenotypes were influenced by gender and associated with lung function in subjects with severe emphysema.
UR - http://www.scopus.com/inward/record.url?scp=68849086909&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=68849086909&partnerID=8YFLogxK
U2 - 10.1378/chest.08-2858
DO - 10.1378/chest.08-2858
M3 - Article
C2 - 19411295
AN - SCOPUS:68849086909
SN - 0012-3692
VL - 136
SP - 396
EP - 404
JO - CHEST
JF - CHEST
IS - 2
ER -