Interstitial Lung Abnormalities, Emphysema, and Spirometry in Smokers.

Autor:	Menon AA; Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Putman RK; Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Sanders JL; Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Hino T; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Hata A; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Radiology, Osaka University, Osaka, Japan., Nishino M; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Ghosh AJ; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA., Ash SY; Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Rosas IO; Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX., Cho MH; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA., Lynch DA; Department of Radiology, National Jewish Health, and University of Colorado at Denver Health Sciences Center, Denver, CO., Washko GR; Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Silverman EK; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA., Hatabu H; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Hunninghake GM; Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Electronic address: ghunninghake@bwh.harvard.edu.
Jazyk:	angličtina
Zdroj:	Chest [Chest] 2022 Apr; Vol. 161 (4), pp. 999-1010. Date of Electronic Publication: 2021 Nov 03.
DOI:	10.1016/j.chest.2021.10.034
Abstrakt:	Background: Most pulmonary conditions reduce FVC, but studies of patients with combined pulmonary fibrosis and emphysema demonstrate that reductions in FVC are less than expected when these two conditions coexist clinically. Research Question: Do interstitial lung abnormalities (ILAs), chest CT imaging findings that may suggest an early stage of pulmonary fibrosis in individuals with undiagnosed disease, affect the association between emphysema and FVC? Study Design and Methods: Measures of ILA and emphysema were available for 9,579 and 5,277 participants from phases 1 (2007-2011) and 2 (2012-2016) of the Genetic Epidemiology of Chronic Obstructive Pulmonary Disease Study (COPDGene), respectively. ILA were defined by Fleischner Society guidelines. Adjusted linear regression models were used to assess the associations and interactions among ILA, emphysema, measures of spirometry, and lung function. Results: ILA were present in 528 (6%) and 580 (11%) of participants in phases 1 and 2 of COPDGene, respectively. ILA modified the association between emphysema and FVC (P < .0001 for interaction) in both phases. In phase 1, in those without ILA, a 5% increase in emphysema was associated with a reduction in FVC (-110 mL; 95% CI, -121 to -100 mL; P < .0001); however, in those with ILA, it was not (-11 mL; 95% CI, -53 to 31; P = .59). In contrast, no interaction was found between ILA and emphysema on total lung capacity or on diffusing capacity of carbon monoxide. Interpretation: The presence of ILA attenuates the reduction in FVC associated with emphysema. (Copyright © 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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