Journal article
Comparison of spatially matched airways reveals thinner airway walls in COPD. The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study and the Subpopulations and Intermediate Outcomes in COPD Study (SPIROMICS)
Thorax, Vol.69(11), pp.987-996
11/2014
DOI: 10.1136/thoraxjnl-2014-205160
PMCID: PMC4198462
PMID: 24928812
Abstract
Background COPD is characterised by reduced airway lumen dimensions and fewer peripheral airways. Most studies of airway properties sample airways based upon lumen dimension or at random, which may bias comparisons given reduced airway lumen dimensions and number in COPD. We sought to compare central airway wall dimensions on CT in COPD and controls using spatially matched airways, thereby avoiding selection bias of airways in the lung. Methods The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study and Subpopulations and Intermediate Outcomes in COPD Study (SPIROMICS) recruited smokers with COPD and controls aged 50–79 years and 40–80 years, respectively. COPD was defined by current guidelines. Using CT image data, airway dimensions were measured for all central airway segments (generations 0–6) following 5 standardised paths into the lungs. Case-control airway comparisons were spatially matched by generation and adjusted for demographics, body size, smoking, CT dose, per cent emphysema, airway length and lung volume. Results Among 311 MESA COPD participants, airway wall areas at generations 3–6 were smaller in COPD compared with controls (all p<0.001). Among 1248 SPIROMICS participants, airway wall areas at generations 1–6 were smaller (all p<0.001), and this reduction was monotonic with increasing COPD severity (p<0.001). In both studies, sampling airways by lumen diameter or randomly resulted in a comparison of more proximal airways in COPD to more peripheral airways in controls (p<0.001) resulting in the appearance of thicker walls in COPD (p<0.02). Conclusions Airway walls are thinner in COPD when comparing spatially matched central airways. Other approaches to airway sampling result in comparisons of more proximal to more distal airways and potentially biased assessment of airway properties in COPD.
Details
- Title: Subtitle
- Comparison of spatially matched airways reveals thinner airway walls in COPD. The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study and the Subpopulations and Intermediate Outcomes in COPD Study (SPIROMICS)
- Creators
- Benjamin M Smith - Department of Medicine, McGill University, Montreal, CanadaEric A Hoffman - Departments of Radiology, Medicine and Biomedical Engineering, University of Iowa, Iowa City, Iowa, USADan Rabinowitz - Department of Statistics, Columbia University, New York, New York, USAEugene Bleecker - Department of Medicine, Wake Forest University, Winston-Salem, North Carolina, USAStephanie Christenson - Department of Medicine, University of California San Francisco, San Francisco, California, USADavid Couper - Deparment of Biostatistics, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USAKathleen M Donohue - Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, USAMeilan K Han - Department of Medicine, University of Michigan, Ann Arbor, Michigan, USANadia N Hansel - Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USARichard E Kanner - Department of Medicine, University of Utah, Salt Lake City, Utah, USAEric Kleerup - Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USAStephen Rennard - Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USAR Graham Barr - Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
- Resource Type
- Journal article
- Publication Details
- Thorax, Vol.69(11), pp.987-996
- DOI
- 10.1136/thoraxjnl-2014-205160
- PMID
- 24928812
- PMCID
- PMC4198462
- ISSN
- 0040-6376
- eISSN
- 1468-3296
- Language
- English
- Date published
- 11/2014
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
- Record Identifier
- 9984051550802771
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