Journal article
Longitudinal Changes in Airway Remodeling and Air Trapping in Severe Asthma
Academic radiology, Vol.21(8), pp.986-993
08/2014
DOI: 10.1016/j.acra.2014.05.001
PMCID: PMC4100072
PMID: 25018070
Abstract
Previous cross-sectional studies have demonstrated that airway wall thickness and air trapping are greater in subjects with severe asthma than in those with mild-to-moderate asthma. However, a better understanding of how airway remodeling and lung density change over time is needed. This study aimed to evaluate predictors of airway wall remodeling and change in lung function and lung density over time in severe asthma.
Phenotypic characterization and quantitative multidetector-row computed tomography (MDCT) of the chest were performed at baseline and ∼2.6 years later in 38 participants with asthma (severe n = 24 and mild-to-moderate n = 14) and nine normal controls from the Severe Asthma Research Program.
Subjects with severe asthma had a significant decline in postbronchodilator forced expiratory volume in 1 second percent (FEV1%) predicted over time (P < .001). Airway wall thickness measured by MDCT was increased at multiple airway generations in severe asthma compared to mild-to-moderate asthma (wall area percent [WA%]: P < .05) and normals (P < .05) at baseline and year 2. Over time, there was an increase in WA% and wall thickness percent (WT%) in all subjects (P = .030 and .009, respectively) with no change in emphysema-like lung or air trapping. Baseline prebronchodilator FEV1% inversely correlated with WA% and WT% (both P < .05). In a multivariable regression model, baseline WA%, race, and health care utilization were predictors of subsequent airway remodeling.
Severe asthma subjects have a greater decline in lung function over time than normal subjects or those with mild-to-moderate asthma. MDCT provides a noninvasive measure of airway wall thickness that may predict subsequent airway remodeling.
Details
- Title: Subtitle
- Longitudinal Changes in Airway Remodeling and Air Trapping in Severe Asthma
- Creators
- Chad A Witt - Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093Ajay Sheshadri - Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093Luke Carlstrom - Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093Jaime Tarsi - Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093James Kozlowski - Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093Brad Wilson - Division of Biostatistics, Washington University School of Medicine, St. Louis, MissouriDavid S Gierada - Department of Radiology, Washington University School of Medicine, St. Louis, MissouriEric Hoffman - Department of Radiology, University of Iowa College of Medicine, Iowa City, IowaSean B Fain - Department of Medical Physics, University of Wisconsin, Madison, WisconsinJanice Cook-Granroth - Department of Radiology, University of Iowa College of Medicine, Iowa City, IowaGeneline Sajol - Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093Oscar Sierra - Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093Tusar Giri - Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093Michael O'Neill - Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093Jie Zheng - Division of Biostatistics, Washington University School of Medicine, St. Louis, MissouriKenneth B Schechtman - Division of Biostatistics, Washington University School of Medicine, St. Louis, MissouriLeonard B Bacharier - Division of Pediatric Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MissouriNizar Jarjour - Division of Pulmonary and Critical Care, University of Wisconsin, Madison, WisconsinWilliam Busse - Division of Allergy and Immunology, University of Wisconsin, Madison, WisconsinMario Castro - Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093
- Resource Type
- Journal article
- Publication Details
- Academic radiology, Vol.21(8), pp.986-993
- DOI
- 10.1016/j.acra.2014.05.001
- PMID
- 25018070
- PMCID
- PMC4100072
- NLM abbreviation
- Acad Radiol
- ISSN
- 1076-6332
- eISSN
- 1878-4046
- Publisher
- Elsevier Inc
- Grant note
- HL69149; HL64368; HL69349; HL69170; HL-69155; HL69174; HL69130; HL69167; HL69116; HL69174 / National Institutes of Health National Heart, Lung, and Blood Institute (http://dx.doi.org/10.13039/100000050) National Institutes of Health (http://dx.doi.org/10.13039/100000002) M01RR00036 / The Hartwell Foundation
- Language
- English
- Date published
- 08/2014
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Iowa Neuroscience Institute; Health, Sport, and Human Physiology ; Internal Medicine
- Record Identifier
- 9984051756002771
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