Airway Tapering in Chronic Obstructive Pulmonary Disease

Sandeep Bodduluri; Arie Nakhmani; Abhilash S Kizhakke Puliyakote; Joseph M Reinhardt; Mark T Dransfield; Surya P Bhatt

doi:10.1183/13993003.00191-2024

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Airway Tapering in Chronic Obstructive Pulmonary Disease

Journal article

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Peer reviewed

Airway Tapering in Chronic Obstructive Pulmonary Disease

Sandeep Bodduluri, Arie Nakhmani, Abhilash S Kizhakke Puliyakote, Joseph M Reinhardt, Mark T Dransfield and Surya P Bhatt

The European respiratory journal, Vol.64(6), 2400191

12/2024

DOI: 10.1183/13993003.00191-2024

PMCID: PMC11624106

PMID: 39326917

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Abstract

Background: Luminal narrowing is a hallmark feature of airway remodeling in COPD, but current measures focus on airway wall remodeling. Quantification of the natural increase in cumulative cross-sectional area along the length of the human airway tree can facilitate assessment of airway narrowing. Methods: We analysed the airway trees of 7641 subjects enrolled in the multicenter COPDGene cohort. Airway luminal tapering was assessed by estimating the slope of the change in cumulative cross-sectional area along the length of the airway tree over successive generations (T-Slope). We performed multivariable regression analyses to test the associations between T-Slope and lung function, St. George's Respiratory Questionnaire (SGRQ), modified Medical Research Council (mMRC) dyspnea score, 6-minute walk distance (6 MWD), FEV1 change, exacerbations, and all-cause mortality after adjusting for demographics, %CT emphysema, and total airway count. Results: The T-Slope decreased with increasing COPD severity: 2.69 (0.70) in nonsmokers and 2.33 (0.70), 2.11 (0.65), 1.78 (0.58), 1.60 (0.53), and 1.57 (0.52) in GOLD stages 0 through 4 respectively (Jonckheere-Terpstra p=0.04). On multivariable analyses, the T-Slope was independently associated with FEV1 (β=0.13 L, 95% CI 0.10 to 0.15, p<0.001), 6MWD (β=15.0 m, 95%CI 10.8 to 19.2, p<0.001), change in FEV1 (β=-4.50 ml·year-1, 95% CI -7.32 to -1.67; p=0.001), exacerbations (IRR=0.78, 95% CI 0.73 to 0.83, p<0.001), and mortality (HR=0.79, 95% CI 0.72 to 0.86, p<0.001). Conclusion: T-Slope is a measure of airway luminal remodeling and is associated with respiratory morbidity and mortality.

Details

Title: Subtitle: Airway Tapering in Chronic Obstructive Pulmonary Disease
Creators: Sandeep Bodduluri - University of Alabama at Birmingham
Arie Nakhmani - University of Alabama at Birmingham
Abhilash S Kizhakke Puliyakote - University of Iowa
Joseph M Reinhardt - University of Iowa
Mark T Dransfield - University of Alabama at Birmingham
Surya P Bhatt - University of Alabama at Birmingham
Resource Type: Journal article
Publication Details: The European respiratory journal, Vol.64(6), 2400191
DOI: 10.1183/13993003.00191-2024
PMID: 39326917
PMCID: PMC11624106
NLM abbreviation: Eur Respir J
ISSN: 0903-1936
eISSN: 1399-3003
Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD
Grant note: NHLBI: U01 HL089897, U01 HL089856, R01 HL151421, K01 HL163249 NIBIB: R21 EB027891 COPD Foundation: NCT00608764
This work was supported by NHLBI R01 HL151421 (S.P. Bhatt and A. Nakhmani) , NIBIB R21 EB027891 (S.P. Bhatt) , NHLBI K01 HL163249 (S. Bodduluri) , and NHLBI U01 HL089897 and U01 HL089856. The COPDGene study (ClinicalTrials.gov: NCT00608764) is also supported by the COPD Foundation through contributions made to an Industry Advisory Committee comprised of AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis and Sunovion. Funding information for this article has been deposited with the Crossref Funder Registry.
Language: English
Electronic publication date: 09/26/2024
Date published: 12/2024
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology
Record Identifier: 9984721250202771

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