Association between functional small airway disease and FEV1 decline in chronic obstructive pulmonary disease
The small conducting airways are the major site of airflow obstruction in chronic obstructive pulmonary disease and may precede emphysema development. We hypothesized a novel computed tomography (CT) biomarker of small airway disease predicts FEV1 decline. We analyzed 1,508 current and former smoker...
Gespeichert in:
| Veröffentlicht in: | American journal of respiratory and critical care medicine 2016-07, Vol.194 (2), p.178-184, Article 178 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 184 |
|---|---|
| container_issue | 2 |
| container_start_page | 178 |
| container_title | American journal of respiratory and critical care medicine |
| container_volume | 194 |
| creator | Bhatt, Surya P Soler, Xavier Wang, Xin Murray, Susan Anzueto, Antonio R Beaty, Terri H Boriek, Aladin M Casaburi, Richard Criner, Gerard J Diaz, Alejandro A Dransfield, Mark T Curran-Everett, Douglas Galbán, Craig J Hoffman, Eric A Hogg, James C Kazerooni, Ella A Kim, Victor Kinney, Gregory L Lagstein, Amir Lynch, David A Make, Barry J Martinez, Fernando J Ramsdell, Joe W Reddy, Rishindra Ross, Brian D Rossiter, Harry B Steiner, Robert M Strand, Matthew J van Beek, Edwin J R Wan, Emily S Washko, George R Wells, J Michael Wendt, Chris H Wise, Robert A Silverman, Edwin K Crapo, James D Bowler, Russell P Han, MeiLan K |
| description | The small conducting airways are the major site of airflow obstruction in chronic obstructive pulmonary disease and may precede emphysema development.
We hypothesized a novel computed tomography (CT) biomarker of small airway disease predicts FEV1 decline.
We analyzed 1,508 current and former smokers from COPDGene with linear regression to assess predictors of change in FEV1 (ml/yr) over 5 years. Separate models for subjects without and with airflow obstruction were generated using baseline clinical and physiologic predictors in addition to two novel CT metrics created by parametric response mapping (PRM), a technique pairing inspiratory and expiratory CT images to define emphysema (PRM(emph)) and functional small airways disease (PRM(fSAD)), a measure of nonemphysematous air trapping.
Mean (SD) rate of FEV1 decline in ml/yr for GOLD (Global Initiative for Chronic Obstructive Lung Disease) 0-4 was as follows: 41.8 (47.7), 53.8 (57.1), 45.6 (61.1), 31.6 (43.6), and 5.1 (35.8), respectively (trend test for grades 1-4; P |
| doi_str_mv | 10.1164/rccm.201511-2219oc |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5003216</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1804867537</sourcerecordid><originalsourceid>FETCH-LOGICAL-c425t-def644d97e9f758088c0efe51490756688c3d44b2ce09463f8a5e3389c49a1a53</originalsourceid><addsrcrecordid>eNpVUctuFDEQtBCIPOAHOCAfuUziHj_GviBFUUIiReICiJvl9fQQI4-92DOJ8vd4syEKp35VV7W6CPkA7ARAidPi_XzSM5AAXd-Dyf4VOQTJZSfMwF63nA28E8L8PCBHtf5mDHoN7C056JVmWoE8JPNZrdkHt4Sc6AaXe8REpzX5XcNFWmcXI3Wh3LsHOoaKriJ1aaSXFz-AjuhjSEhDov625BQ8zZu6lLWt3yHdrnFuLOV58x15M7lY8f1TPCbfLy--nV91N1-_XJ-f3XRe9HLpRpyUEKMZ0EyDbKdqz3BCCcKwQSrVaj4Ksek9MiMUn7STyLk2XhgHTvJj8nnPu103M44e01JctNsS5naNzS7Y_ycp3Npf-c5KxngPqhF8eiIo-c-KdbFzqB5jdAnzWi1oJrQaJB8a9ONLrWeRfz9uAL0H-JJrLThZH5bHhzfpEC0wu7PT7uy0ezvt3k7-FwBUlSo</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1804867537</pqid></control><display><type>article</type><title>Association between functional small airway disease and FEV1 decline in chronic obstructive pulmonary disease</title><source>MEDLINE</source><source>American Thoracic Society (ATS) Journals Online</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><source>Journals@Ovid Complete</source><creator>Bhatt, Surya P ; Soler, Xavier ; Wang, Xin ; Murray, Susan ; Anzueto, Antonio R ; Beaty, Terri H ; Boriek, Aladin M ; Casaburi, Richard ; Criner, Gerard J ; Diaz, Alejandro A ; Dransfield, Mark T ; Curran-Everett, Douglas ; Galbán, Craig J ; Hoffman, Eric A ; Hogg, James C ; Kazerooni, Ella A ; Kim, Victor ; Kinney, Gregory L ; Lagstein, Amir ; Lynch, David A ; Make, Barry J ; Martinez, Fernando J ; Ramsdell, Joe W ; Reddy, Rishindra ; Ross, Brian D ; Rossiter, Harry B ; Steiner, Robert M ; Strand, Matthew J ; van Beek, Edwin J R ; Wan, Emily S ; Washko, George R ; Wells, J Michael ; Wendt, Chris H ; Wise, Robert A ; Silverman, Edwin K ; Crapo, James D ; Bowler, Russell P ; Han, MeiLan K</creator><creatorcontrib>Bhatt, Surya P ; Soler, Xavier ; Wang, Xin ; Murray, Susan ; Anzueto, Antonio R ; Beaty, Terri H ; Boriek, Aladin M ; Casaburi, Richard ; Criner, Gerard J ; Diaz, Alejandro A ; Dransfield, Mark T ; Curran-Everett, Douglas ; Galbán, Craig J ; Hoffman, Eric A ; Hogg, James C ; Kazerooni, Ella A ; Kim, Victor ; Kinney, Gregory L ; Lagstein, Amir ; Lynch, David A ; Make, Barry J ; Martinez, Fernando J ; Ramsdell, Joe W ; Reddy, Rishindra ; Ross, Brian D ; Rossiter, Harry B ; Steiner, Robert M ; Strand, Matthew J ; van Beek, Edwin J R ; Wan, Emily S ; Washko, George R ; Wells, J Michael ; Wendt, Chris H ; Wise, Robert A ; Silverman, Edwin K ; Crapo, James D ; Bowler, Russell P ; Han, MeiLan K ; COPDGene Investigators</creatorcontrib><description>The small conducting airways are the major site of airflow obstruction in chronic obstructive pulmonary disease and may precede emphysema development.
We hypothesized a novel computed tomography (CT) biomarker of small airway disease predicts FEV1 decline.
We analyzed 1,508 current and former smokers from COPDGene with linear regression to assess predictors of change in FEV1 (ml/yr) over 5 years. Separate models for subjects without and with airflow obstruction were generated using baseline clinical and physiologic predictors in addition to two novel CT metrics created by parametric response mapping (PRM), a technique pairing inspiratory and expiratory CT images to define emphysema (PRM(emph)) and functional small airways disease (PRM(fSAD)), a measure of nonemphysematous air trapping.
Mean (SD) rate of FEV1 decline in ml/yr for GOLD (Global Initiative for Chronic Obstructive Lung Disease) 0-4 was as follows: 41.8 (47.7), 53.8 (57.1), 45.6 (61.1), 31.6 (43.6), and 5.1 (35.8), respectively (trend test for grades 1-4; P < 0.001). In multivariable linear regression, for participants without airflow obstruction, PRM(fSAD) but not PRM(emph) was associated with FEV1 decline (P < 0.001). In GOLD 1-4 participants, both PRM(fSAD) and PRM(emph) were associated with FEV1 decline (P < 0.001 and P = 0.001, respectively). Based on the model, the proportional contribution of the two CT metrics to FEV1 decline, relative to each other, was 87% versus 13% and 68% versus 32% for PRM(fSAD) and PRM(emph) in GOLD 1/2 and 3/4, respectively.
CT-assessed functional small airway disease and emphysema are associated with FEV1 decline, but the association with functional small airway disease has greatest importance in mild-to-moderate stage chronic obstructive pulmonary disease where the rate of FEV1 decline is the greatest. Clinical trial registered with www.clinicaltrials.gov (NCT 00608764).</description><identifier>ISSN: 1073-449X</identifier><identifier>EISSN: 1535-4970</identifier><identifier>DOI: 10.1164/rccm.201511-2219oc</identifier><identifier>PMID: 26808615</identifier><language>eng</language><publisher>United States: American Thoracic Society</publisher><subject>Female ; Forced Expiratory Volume - physiology ; Humans ; Lung - diagnostic imaging ; Lung - physiopathology ; Male ; Middle Aged ; Original ; Pulmonary Disease, Chronic Obstructive - diagnostic imaging ; Pulmonary Disease, Chronic Obstructive - physiopathology ; Respiratory System - diagnostic imaging ; Respiratory System - physiopathology ; Spirometry ; Tomography, X-Ray Computed</subject><ispartof>American journal of respiratory and critical care medicine, 2016-07, Vol.194 (2), p.178-184, Article 178</ispartof><rights>Copyright © 2016 by the American Thoracic Society 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c425t-def644d97e9f758088c0efe51490756688c3d44b2ce09463f8a5e3389c49a1a53</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26808615$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bhatt, Surya P</creatorcontrib><creatorcontrib>Soler, Xavier</creatorcontrib><creatorcontrib>Wang, Xin</creatorcontrib><creatorcontrib>Murray, Susan</creatorcontrib><creatorcontrib>Anzueto, Antonio R</creatorcontrib><creatorcontrib>Beaty, Terri H</creatorcontrib><creatorcontrib>Boriek, Aladin M</creatorcontrib><creatorcontrib>Casaburi, Richard</creatorcontrib><creatorcontrib>Criner, Gerard J</creatorcontrib><creatorcontrib>Diaz, Alejandro A</creatorcontrib><creatorcontrib>Dransfield, Mark T</creatorcontrib><creatorcontrib>Curran-Everett, Douglas</creatorcontrib><creatorcontrib>Galbán, Craig J</creatorcontrib><creatorcontrib>Hoffman, Eric A</creatorcontrib><creatorcontrib>Hogg, James C</creatorcontrib><creatorcontrib>Kazerooni, Ella A</creatorcontrib><creatorcontrib>Kim, Victor</creatorcontrib><creatorcontrib>Kinney, Gregory L</creatorcontrib><creatorcontrib>Lagstein, Amir</creatorcontrib><creatorcontrib>Lynch, David A</creatorcontrib><creatorcontrib>Make, Barry J</creatorcontrib><creatorcontrib>Martinez, Fernando J</creatorcontrib><creatorcontrib>Ramsdell, Joe W</creatorcontrib><creatorcontrib>Reddy, Rishindra</creatorcontrib><creatorcontrib>Ross, Brian D</creatorcontrib><creatorcontrib>Rossiter, Harry B</creatorcontrib><creatorcontrib>Steiner, Robert M</creatorcontrib><creatorcontrib>Strand, Matthew J</creatorcontrib><creatorcontrib>van Beek, Edwin J R</creatorcontrib><creatorcontrib>Wan, Emily S</creatorcontrib><creatorcontrib>Washko, George R</creatorcontrib><creatorcontrib>Wells, J Michael</creatorcontrib><creatorcontrib>Wendt, Chris H</creatorcontrib><creatorcontrib>Wise, Robert A</creatorcontrib><creatorcontrib>Silverman, Edwin K</creatorcontrib><creatorcontrib>Crapo, James D</creatorcontrib><creatorcontrib>Bowler, Russell P</creatorcontrib><creatorcontrib>Han, MeiLan K</creatorcontrib><creatorcontrib>COPDGene Investigators</creatorcontrib><title>Association between functional small airway disease and FEV1 decline in chronic obstructive pulmonary disease</title><title>American journal of respiratory and critical care medicine</title><addtitle>Am J Respir Crit Care Med</addtitle><description>The small conducting airways are the major site of airflow obstruction in chronic obstructive pulmonary disease and may precede emphysema development.
We hypothesized a novel computed tomography (CT) biomarker of small airway disease predicts FEV1 decline.
We analyzed 1,508 current and former smokers from COPDGene with linear regression to assess predictors of change in FEV1 (ml/yr) over 5 years. Separate models for subjects without and with airflow obstruction were generated using baseline clinical and physiologic predictors in addition to two novel CT metrics created by parametric response mapping (PRM), a technique pairing inspiratory and expiratory CT images to define emphysema (PRM(emph)) and functional small airways disease (PRM(fSAD)), a measure of nonemphysematous air trapping.
Mean (SD) rate of FEV1 decline in ml/yr for GOLD (Global Initiative for Chronic Obstructive Lung Disease) 0-4 was as follows: 41.8 (47.7), 53.8 (57.1), 45.6 (61.1), 31.6 (43.6), and 5.1 (35.8), respectively (trend test for grades 1-4; P < 0.001). In multivariable linear regression, for participants without airflow obstruction, PRM(fSAD) but not PRM(emph) was associated with FEV1 decline (P < 0.001). In GOLD 1-4 participants, both PRM(fSAD) and PRM(emph) were associated with FEV1 decline (P < 0.001 and P = 0.001, respectively). Based on the model, the proportional contribution of the two CT metrics to FEV1 decline, relative to each other, was 87% versus 13% and 68% versus 32% for PRM(fSAD) and PRM(emph) in GOLD 1/2 and 3/4, respectively.
CT-assessed functional small airway disease and emphysema are associated with FEV1 decline, but the association with functional small airway disease has greatest importance in mild-to-moderate stage chronic obstructive pulmonary disease where the rate of FEV1 decline is the greatest. Clinical trial registered with www.clinicaltrials.gov (NCT 00608764).</description><subject>Female</subject><subject>Forced Expiratory Volume - physiology</subject><subject>Humans</subject><subject>Lung - diagnostic imaging</subject><subject>Lung - physiopathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Pulmonary Disease, Chronic Obstructive - diagnostic imaging</subject><subject>Pulmonary Disease, Chronic Obstructive - physiopathology</subject><subject>Respiratory System - diagnostic imaging</subject><subject>Respiratory System - physiopathology</subject><subject>Spirometry</subject><subject>Tomography, X-Ray Computed</subject><issn>1073-449X</issn><issn>1535-4970</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUctuFDEQtBCIPOAHOCAfuUziHj_GviBFUUIiReICiJvl9fQQI4-92DOJ8vd4syEKp35VV7W6CPkA7ARAidPi_XzSM5AAXd-Dyf4VOQTJZSfMwF63nA28E8L8PCBHtf5mDHoN7C056JVmWoE8JPNZrdkHt4Sc6AaXe8REpzX5XcNFWmcXI3Wh3LsHOoaKriJ1aaSXFz-AjuhjSEhDov625BQ8zZu6lLWt3yHdrnFuLOV58x15M7lY8f1TPCbfLy--nV91N1-_XJ-f3XRe9HLpRpyUEKMZ0EyDbKdqz3BCCcKwQSrVaj4Ksek9MiMUn7STyLk2XhgHTvJj8nnPu103M44e01JctNsS5naNzS7Y_ycp3Npf-c5KxngPqhF8eiIo-c-KdbFzqB5jdAnzWi1oJrQaJB8a9ONLrWeRfz9uAL0H-JJrLThZH5bHhzfpEC0wu7PT7uy0ezvt3k7-FwBUlSo</recordid><startdate>20160715</startdate><enddate>20160715</enddate><creator>Bhatt, Surya P</creator><creator>Soler, Xavier</creator><creator>Wang, Xin</creator><creator>Murray, Susan</creator><creator>Anzueto, Antonio R</creator><creator>Beaty, Terri H</creator><creator>Boriek, Aladin M</creator><creator>Casaburi, Richard</creator><creator>Criner, Gerard J</creator><creator>Diaz, Alejandro A</creator><creator>Dransfield, Mark T</creator><creator>Curran-Everett, Douglas</creator><creator>Galbán, Craig J</creator><creator>Hoffman, Eric A</creator><creator>Hogg, James C</creator><creator>Kazerooni, Ella A</creator><creator>Kim, Victor</creator><creator>Kinney, Gregory L</creator><creator>Lagstein, Amir</creator><creator>Lynch, David A</creator><creator>Make, Barry J</creator><creator>Martinez, Fernando J</creator><creator>Ramsdell, Joe W</creator><creator>Reddy, Rishindra</creator><creator>Ross, Brian D</creator><creator>Rossiter, Harry B</creator><creator>Steiner, Robert M</creator><creator>Strand, Matthew J</creator><creator>van Beek, Edwin J R</creator><creator>Wan, Emily S</creator><creator>Washko, George R</creator><creator>Wells, J Michael</creator><creator>Wendt, Chris H</creator><creator>Wise, Robert A</creator><creator>Silverman, Edwin K</creator><creator>Crapo, James D</creator><creator>Bowler, Russell P</creator><creator>Han, MeiLan K</creator><general>American Thoracic Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160715</creationdate><title>Association between functional small airway disease and FEV1 decline in chronic obstructive pulmonary disease</title><author>Bhatt, Surya P ; Soler, Xavier ; Wang, Xin ; Murray, Susan ; Anzueto, Antonio R ; Beaty, Terri H ; Boriek, Aladin M ; Casaburi, Richard ; Criner, Gerard J ; Diaz, Alejandro A ; Dransfield, Mark T ; Curran-Everett, Douglas ; Galbán, Craig J ; Hoffman, Eric A ; Hogg, James C ; Kazerooni, Ella A ; Kim, Victor ; Kinney, Gregory L ; Lagstein, Amir ; Lynch, David A ; Make, Barry J ; Martinez, Fernando J ; Ramsdell, Joe W ; Reddy, Rishindra ; Ross, Brian D ; Rossiter, Harry B ; Steiner, Robert M ; Strand, Matthew J ; van Beek, Edwin J R ; Wan, Emily S ; Washko, George R ; Wells, J Michael ; Wendt, Chris H ; Wise, Robert A ; Silverman, Edwin K ; Crapo, James D ; Bowler, Russell P ; Han, MeiLan K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c425t-def644d97e9f758088c0efe51490756688c3d44b2ce09463f8a5e3389c49a1a53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Female</topic><topic>Forced Expiratory Volume - physiology</topic><topic>Humans</topic><topic>Lung - diagnostic imaging</topic><topic>Lung - physiopathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original</topic><topic>Pulmonary Disease, Chronic Obstructive - diagnostic imaging</topic><topic>Pulmonary Disease, Chronic Obstructive - physiopathology</topic><topic>Respiratory System - diagnostic imaging</topic><topic>Respiratory System - physiopathology</topic><topic>Spirometry</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bhatt, Surya P</creatorcontrib><creatorcontrib>Soler, Xavier</creatorcontrib><creatorcontrib>Wang, Xin</creatorcontrib><creatorcontrib>Murray, Susan</creatorcontrib><creatorcontrib>Anzueto, Antonio R</creatorcontrib><creatorcontrib>Beaty, Terri H</creatorcontrib><creatorcontrib>Boriek, Aladin M</creatorcontrib><creatorcontrib>Casaburi, Richard</creatorcontrib><creatorcontrib>Criner, Gerard J</creatorcontrib><creatorcontrib>Diaz, Alejandro A</creatorcontrib><creatorcontrib>Dransfield, Mark T</creatorcontrib><creatorcontrib>Curran-Everett, Douglas</creatorcontrib><creatorcontrib>Galbán, Craig J</creatorcontrib><creatorcontrib>Hoffman, Eric A</creatorcontrib><creatorcontrib>Hogg, James C</creatorcontrib><creatorcontrib>Kazerooni, Ella A</creatorcontrib><creatorcontrib>Kim, Victor</creatorcontrib><creatorcontrib>Kinney, Gregory L</creatorcontrib><creatorcontrib>Lagstein, Amir</creatorcontrib><creatorcontrib>Lynch, David A</creatorcontrib><creatorcontrib>Make, Barry J</creatorcontrib><creatorcontrib>Martinez, Fernando J</creatorcontrib><creatorcontrib>Ramsdell, Joe W</creatorcontrib><creatorcontrib>Reddy, Rishindra</creatorcontrib><creatorcontrib>Ross, Brian D</creatorcontrib><creatorcontrib>Rossiter, Harry B</creatorcontrib><creatorcontrib>Steiner, Robert M</creatorcontrib><creatorcontrib>Strand, Matthew J</creatorcontrib><creatorcontrib>van Beek, Edwin J R</creatorcontrib><creatorcontrib>Wan, Emily S</creatorcontrib><creatorcontrib>Washko, George R</creatorcontrib><creatorcontrib>Wells, J Michael</creatorcontrib><creatorcontrib>Wendt, Chris H</creatorcontrib><creatorcontrib>Wise, Robert A</creatorcontrib><creatorcontrib>Silverman, Edwin K</creatorcontrib><creatorcontrib>Crapo, James D</creatorcontrib><creatorcontrib>Bowler, Russell P</creatorcontrib><creatorcontrib>Han, MeiLan K</creatorcontrib><creatorcontrib>COPDGene Investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of respiratory and critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bhatt, Surya P</au><au>Soler, Xavier</au><au>Wang, Xin</au><au>Murray, Susan</au><au>Anzueto, Antonio R</au><au>Beaty, Terri H</au><au>Boriek, Aladin M</au><au>Casaburi, Richard</au><au>Criner, Gerard J</au><au>Diaz, Alejandro A</au><au>Dransfield, Mark T</au><au>Curran-Everett, Douglas</au><au>Galbán, Craig J</au><au>Hoffman, Eric A</au><au>Hogg, James C</au><au>Kazerooni, Ella A</au><au>Kim, Victor</au><au>Kinney, Gregory L</au><au>Lagstein, Amir</au><au>Lynch, David A</au><au>Make, Barry J</au><au>Martinez, Fernando J</au><au>Ramsdell, Joe W</au><au>Reddy, Rishindra</au><au>Ross, Brian D</au><au>Rossiter, Harry B</au><au>Steiner, Robert M</au><au>Strand, Matthew J</au><au>van Beek, Edwin J R</au><au>Wan, Emily S</au><au>Washko, George R</au><au>Wells, J Michael</au><au>Wendt, Chris H</au><au>Wise, Robert A</au><au>Silverman, Edwin K</au><au>Crapo, James D</au><au>Bowler, Russell P</au><au>Han, MeiLan K</au><aucorp>COPDGene Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between functional small airway disease and FEV1 decline in chronic obstructive pulmonary disease</atitle><jtitle>American journal of respiratory and critical care medicine</jtitle><addtitle>Am J Respir Crit Care Med</addtitle><date>2016-07-15</date><risdate>2016</risdate><volume>194</volume><issue>2</issue><spage>178</spage><epage>184</epage><pages>178-184</pages><artnum>178</artnum><issn>1073-449X</issn><eissn>1535-4970</eissn><abstract>The small conducting airways are the major site of airflow obstruction in chronic obstructive pulmonary disease and may precede emphysema development.
We hypothesized a novel computed tomography (CT) biomarker of small airway disease predicts FEV1 decline.
We analyzed 1,508 current and former smokers from COPDGene with linear regression to assess predictors of change in FEV1 (ml/yr) over 5 years. Separate models for subjects without and with airflow obstruction were generated using baseline clinical and physiologic predictors in addition to two novel CT metrics created by parametric response mapping (PRM), a technique pairing inspiratory and expiratory CT images to define emphysema (PRM(emph)) and functional small airways disease (PRM(fSAD)), a measure of nonemphysematous air trapping.
Mean (SD) rate of FEV1 decline in ml/yr for GOLD (Global Initiative for Chronic Obstructive Lung Disease) 0-4 was as follows: 41.8 (47.7), 53.8 (57.1), 45.6 (61.1), 31.6 (43.6), and 5.1 (35.8), respectively (trend test for grades 1-4; P < 0.001). In multivariable linear regression, for participants without airflow obstruction, PRM(fSAD) but not PRM(emph) was associated with FEV1 decline (P < 0.001). In GOLD 1-4 participants, both PRM(fSAD) and PRM(emph) were associated with FEV1 decline (P < 0.001 and P = 0.001, respectively). Based on the model, the proportional contribution of the two CT metrics to FEV1 decline, relative to each other, was 87% versus 13% and 68% versus 32% for PRM(fSAD) and PRM(emph) in GOLD 1/2 and 3/4, respectively.
CT-assessed functional small airway disease and emphysema are associated with FEV1 decline, but the association with functional small airway disease has greatest importance in mild-to-moderate stage chronic obstructive pulmonary disease where the rate of FEV1 decline is the greatest. Clinical trial registered with www.clinicaltrials.gov (NCT 00608764).</abstract><cop>United States</cop><pub>American Thoracic Society</pub><pmid>26808615</pmid><doi>10.1164/rccm.201511-2219oc</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1073-449X |
| ispartof | American journal of respiratory and critical care medicine, 2016-07, Vol.194 (2), p.178-184, Article 178 |
| issn | 1073-449X 1535-4970 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5003216 |
| source | MEDLINE; American Thoracic Society (ATS) Journals Online; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection; Journals@Ovid Complete |
| subjects | Female Forced Expiratory Volume - physiology Humans Lung - diagnostic imaging Lung - physiopathology Male Middle Aged Original Pulmonary Disease, Chronic Obstructive - diagnostic imaging Pulmonary Disease, Chronic Obstructive - physiopathology Respiratory System - diagnostic imaging Respiratory System - physiopathology Spirometry Tomography, X-Ray Computed |
| title | Association between functional small airway disease and FEV1 decline in chronic obstructive pulmonary disease |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-06T15%3A32%3A25IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Association%20between%20functional%20small%20airway%20disease%20and%20FEV1%20decline%20in%20chronic%20obstructive%20pulmonary%20disease&rft.jtitle=American%20journal%20of%20respiratory%20and%20critical%20care%20medicine&rft.au=Bhatt,%20Surya%20P&rft.aucorp=COPDGene%20Investigators&rft.date=2016-07-15&rft.volume=194&rft.issue=2&rft.spage=178&rft.epage=184&rft.pages=178-184&rft.artnum=178&rft.issn=1073-449X&rft.eissn=1535-4970&rft_id=info:doi/10.1164/rccm.201511-2219oc&rft_dat=%3Cproquest_pubme%3E1804867537%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1804867537&rft_id=info:pmid/26808615&rfr_iscdi=true |