Journal article
Computed Tomography-based Airway Surface Area-to-Volume Ratio for Phenotyping Airway Remodeling in Chronic Obstructive Pulmonary Disease
American journal of respiratory and critical care medicine, Vol.203(2), pp.185-191
01/15/2021
DOI: 10.1164/rccm.202004-0951OC
PMCID: PMC7874421
PMID: 32755486
Abstract
Airway remodeling in chronic obstructive pulmonary disease (COPD) is due to luminal narrowing and/or loss of airways. Existing computed tomographic metrics of airway disease reflect only components of these processes. With progressive airway narrowing, the ratio of the airway luminal surface area to volume (SA/V) should increase, and with predominant airway loss, SA/V should decrease.
To phenotype airway remodeling in COPD.
We analyzed the airway trees of 4,325 subjects with COPD Global Initiative for Chronic Obstructive Lung Disease stages 0 to 4 and 73 nonsmokers enrolled in the multicenter COPDGene (Genetic Epidemiology of COPD) cohort. Surface area and volume measurements were estimated for the subtracheal airway tree to derive SA/V. We performed multivariable regression analyses to test associations between SA/V and lung function, 6-minute-walk distance, St. George's Respiratory Questionnaire, change in FEV
, and mortality, adjusting for demographics, total airway count, airway wall thickness, and emphysema. On the basis of the change in SA/V over 5 years, we categorized subjects into predominant airway narrowing [positive ∆(SA/V) more than 0] and predominant airway loss [negative ∆(SA/V) less than 0] and compared survival between the two groups.
Airway SA/V was independently associated with FEV
/FVC (β = 0.12; 95% confidence interval [CI], 0.09-0.14;
< 0.001) and FEV
% predicted (β = 20.10; 95% CI, 15.13-25.08;
< 0.001). Airway SA/V was also independently associated with 6-minute-walk distance, respiratory quality of life, and lung function decline. Compared with subjects with predominant airway narrowing (
= 2,914; 66.3%), those with predominant airway loss (
= 1,484; 33.7%) had worse survival (adjusted hazard ratio for all-cause mortality = 1.58; 95% CI, 1.18-2.13;
= 0.002).
Computed tomography-based airway SA/V is an imaging biomarker of airway remodeling and provides differential information on predominant airway narrowing and loss in COPD. SA/V is associated with respiratory morbidity, lung function decline, and survival.
Details
- Title: Subtitle
- Computed Tomography-based Airway Surface Area-to-Volume Ratio for Phenotyping Airway Remodeling in Chronic Obstructive Pulmonary Disease
- Creators
- Sandeep Bodduluri - University of Alabama at BirminghamAbhilash Kizhakke Puliyakote - University of Alabama at BirminghamArie Nakhmani - University of Alabama at BirminghamJean-Paul Charbonnier - Thirona, Nijmegen, the Netherlands; andJoseph M Reinhardt - University of IowaSurya P Bhatt - University of Alabama at Birmingham
- Resource Type
- Journal article
- Publication Details
- American journal of respiratory and critical care medicine, Vol.203(2), pp.185-191
- DOI
- 10.1164/rccm.202004-0951OC
- PMID
- 32755486
- PMCID
- PMC7874421
- ISSN
- 1073-449X
- eISSN
- 1535-4970
- Grant note
- U01 HL089856 / NHLBI NIH HHS K23 HL133438 / NHLBI NIH HHS R21 EB027891 / NIBIB NIH HHS P30 DK054759 / NIDDK NIH HHS R01 HL151421 / NHLBI NIH HHS
- Language
- English
- Date published
- 01/15/2021
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology
- Record Identifier
- 9984197000002771
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