Association of quantitative CT lung density measurements and lung function decline in World Trade Center workers
| Autor: | Yunho Jeon, Raúl San José Estépar, John Doucette, Rafael E. de la Hoz, Anthony P. Reeves, Katherine Antoniak, Jonathan Weber, Xiaoyu Liu, Dongming Xu, Juan C. Celedón |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Lung Diseases Male medicine.medical_specialty CT–lung inhalation injury helical computed tomography 03 medical and health sciences 0302 clinical medicine occupational respiratory diseases Internal medicine Forced Expiratory Volume Occupational Exposure Linear regression medicine Immunology and Allergy Humans 030212 general & internal medicine Quantitative computed tomography Child Lung Genetics (clinical) Lung function imaging of the chest medicine.diagnostic_test business.industry lung function decline World trade center Original Articles multivariate analysis of prognostic factors World Trade Center‐related lung disease Lung density medicine.anatomical_structure 030228 respiratory system Cohort Cardiology Population study Original Article Female September 11 Terrorist Attacks business Tomography X-Ray Computed lung function trajectories |
| Zdroj: | The Clinical Respiratory Journal |
| ISSN: | 1752-699X 1752-6981 |
| Popis: | Background Occupational exposures at the WTC site after 11 September 2001 have been associated with presumably inflammatory chronic lower airway diseases. Aims In this study, we describe the trajectories of expiratory air flow decline, identify subgroups with adverse progression, and investigate the association of those trajectories with quantitative computed tomography (QCT) imaging measurement of increased and decreased lung density. Methods We examined the trajectories of expiratory air flow decline in a group of 1,321 former WTC workers and volunteers with at least three periodic spirometries, and using QCT‐measured low (LAV%, −950 HU) and high (HAV%, from −600 to −250 HU) attenuation volume percent. We calculated the individual regression line slopes for first‐second forced expiratory volume (FEV1slope), identified subjects with rapidly declining (“accelerated decliners”) and increasing (“improved”), and compared them to subjects with “intermediate” (0 to −66.5 mL/year) FEV1slope. We then used multinomial logistic regression to model those three trajectories, and the two lung attenuation metrics. Results The mean longitudinal FEV1 slopes for the entire study population, and its intermediate, decliner, and improved subgroups were, respectively, −40.4, −34.3, −106.5, and 37.6 mL/year. In unadjusted and adjusted analyses, LAV% and HAV% were both associated with “accelerated decliner” status (ORadj, 95% CI 2.37, 1.41–3.97, and 1.77, 1.08–2.89, respectively), compared to the intermediate decline. Conclusions Longitudinal FEV1 decline in this cohort, known to be associated with QCT proximal airway inflammation metric, is also associated with QCT indicators of increased and decreased lung density. The improved FEV1 trajectory did not seem to be associated with lung density metrics. |
| Databáze: | OpenAIRE |
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