Journal article
A Novel Air Trapping Segment Score Identifies Opposing Effects of Obesity and Eosinophilia on Air Trapping in Asthma
American journal of respiratory and critical care medicine, Vol.209(10), pp.1196-1207
05/2024
DOI: 10.1164/rccm.202305-0802OC
PMCID: PMC11146546
PMID: 38113166
Abstract
Density thresholds in computed tomography (CT) lung scans quantify air trapping (AT) at the whole lung level but are not informative for AT in specific bronchopulmonary segments.
To apply a segment-based measure of AT in asthma to investigate the clinical determinants of AT in asthma.
In each of 19 bronchopulmonary segments in CT lung scans from 199 asthma patients, AT was categorized as present if lung attenuation was < -856 Hounsfield units at expiration in ≥ 15% of lung area. The resulting AT segment score (0-19) was related to patient outcomes.
AT varied at the lung segment level and tended to persist at the patient and lung segment level over 3 years. Patients with widespread AT (>10 segments) had more severe asthma (p<0.05). The mean (± SD) AT segment score in patients with a BMI > 30 was lower than in patients with a BMI < 30 (3.5 ± 4.6 vs. 5.5 ± 6.3, p=0.008), and the frequency of AT in lower lobe segments in obese patients was less than in upper and middle lobe segments (35 vs. 46%, p=0.001). The AT segment score in patients with sputum eosinophil % > 2 was higher than in patients without sputum eosinophilia (7.0 ± 6.1 vs. 3.3 ± 4.9, p<0.0001). Lung segments with AT more frequently had airway mucus plugging than lung segments without AT (48 vs. 18%, p≤0.0001).
In patients with asthma, air trapping is more severe in those with airway eosinophilia and mucus plugging whereas those who are obese have less severe trapping because their lower lobe segments are spared.
Details
- Title: Subtitle
- A Novel Air Trapping Segment Score Identifies Opposing Effects of Obesity and Eosinophilia on Air Trapping in Asthma
- Creators
- Clarus Leung - University of California, San FranciscoMonica Tang - University of California, San FranciscoBrendan K Huang - University of California, San FranciscoSean B Fain - University of IowaEric A Hoffman - University of Iowa Carver College of Medicine, Radiology, Iowa City, Iowa, United StatesJiwoong Choi - University of KansasEleanor M Dunican - University College DublinDavid T Mauger - Pennsylvania State UniversityLoren C Denlinger - University of Wisconsin, Medicine-Allergy, Pulmonary and Critical Care Medicine, Madison, Wisconsin, United StatesNizar N Jarjour - University of Wisconsin School of Medicine and Public HealthElliot Israel - Brigham and Women's HospitalBruce D Levy - Brigham and Women's HospitalSally E Wenzel - Dept of EOH, Pittsburgh, Pennsylvania, United StatesKaharu Sumino - Washington University School of Medicine, Division of Pulmonary and Critical Care Medicine, St. Louis, Missouri, United StatesAnnette T Hastie - Wake Forest UniversityJoshua Schirm - Vida Diagnostics (United States)Charles E McCulloch - University of California, San FranciscoMichael C Peters - University of California, San FranciscoPrescott G Woodruff - University of California, San FranciscoRonald L Sorkness - University of Wisconsin–MadisonMario Castro - University of KansasJohn V FahyNHLBI Severe Asthma Research Program (SARP)
- Resource Type
- Journal article
- Publication Details
- American journal of respiratory and critical care medicine, Vol.209(10), pp.1196-1207
- DOI
- 10.1164/rccm.202305-0802OC
- PMID
- 38113166
- PMCID
- PMC11146546
- NLM abbreviation
- Am J Respir Crit Care Med
- ISSN
- 1073-449X
- eISSN
- 1535-4970
- Language
- English
- Electronic publication date
- 12/19/2023
- Date published
- 05/2024
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Iowa Neuroscience Institute; Health, Sport, and Human Physiology ; Mechanical Engineering; Internal Medicine
- Record Identifier
- 9984532212402771
Metrics
18 Record Views