Progression of Emphysema and Small Airways Disease in Cigarette Smokers
| Autor: | E.K. Silverman, MeiLan K. Han, Craig J. Galbán, Barry J. Make, Elisabeth A Regan, James D. Crapo, Jean-Paul Charbonnier, Steven M Humphries, COPDGene Investigators, David A. Lynch, Matthew Strand, Camille M. Moore, Pim A. de Jong, George R. Washko, Jan-Willem J. Lammers, Firdaus A. A. Mohamed Hoesein, Charles R. Hatt, Esther Pompe, Eva M. van Rikxoort |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
Spirometry medicine.medical_specialty COPD medicine.diagnostic_test business.industry Retrospective cohort study Odds ratio respiratory system Air trapping medicine.disease Logistic regression Origianl Research Obstructive lung disease respiratory tract diseases All institutes and research themes of the Radboud University Medical Center Genetic epidemiology Internal medicine Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5] Cardiology Medicine medicine.symptom business |
| Zdroj: | Chronic Obstr Pulm Dis Chronic Obstructive Pulmonary Diseases : Journal of the COPD Foundation, 8, 2, pp. 198-212 Chronic Obstructive Pulmonary Diseases. Journal of the Copd Foundation, 8, 198-212 |
| ISSN: | 2372-952X |
| Popis: | Background: Little is known about factors associated with emphysema progression in cigarette smokers. We evaluated factors associated with change in emphysema and forced expiratory volume in 1 second (FEV(1)) in participants with and without chronic obstructive pulmonary disease (COPD). Methods: This retrospective study included individuals participating in the COPD Genetic Epidemiology study who completed the 5-year follow-up, including inspiratory and expiratory computed tomography (CT) and spirometry. All paired CT scans were analyzed using micro-mapping, which classifies individual voxels as emphysema or functional small airway disease (fSAD). Presence and progression of emphysema and FEV(1) were determined based on comparison to nonsmoker values. Logistic regression analyses were used to identify clinical parameters associated with disease progression. Results: A total of 3088 participants were included with a mean ± SD age of 60.7±8.9 years, including 72 nonsmokers. In all Global initiative for chronic Obstructive Lung Disease (GOLD) stages, the presence of emphysema at baseline was associated with emphysema progression (odds ratio [OR]: GOLD 0: 4.32; preserved ratio-impaired spirometry [PRISm]; 5.73; GOLD 1: 5.16; GOLD 2: 5.69; GOLD 3/4: 5.55; all p ≤0.01). If there was no emphysema at baseline, the amount of fSAD at baseline was associated with emphysema progression (OR for 1% increase: GOLD 0: 1.06; PRISm: 1.20; GOLD 1: 1.7; GOLD 3/4: 1.08; all p ≤ 0.03).In 1735 participants without spirometric COPD, progression in emphysema occurred in 105 (6.1%) participants and only 21 (1.2%) had progression in both emphysema and FEV(1). Conclusions: The presence of emphysema is an important predictor of emphysema progression. In patients without emphysema, fSAD is associated with the development of emphysema. In participants without spirometric COPD, emphysema progression occurred independently of FEV(1) decline. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|