Quantitative CT metrics are associated with longitudinal lung function decline and future asthma exacerbations: Results from SARP-3

James G Krings; Charles W Goss; Daphne Lew; Maanasi Samant; Mary Clare McGregor; Jonathan Boomer; Leonard B Bacharier; Ajay Sheshadri; Chase Hall; Joshua Brownell; Ken B Schechtman; Samuel Peterson; Stephen McEleney; David T Mauger; John V Fahy; Sean B Fain; Loren C Denlinger; Elliot Israel; George Washko; Eric Hoffman; Sally E Wenzel; Mario Castro; National Heart, Lung, and Blood Institute’s Severe Asthma Research Program Investigators

doi:10.1016/j.jaci.2021.01.029

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Quantitative CT metrics are associated with longitudinal lung function decline and future asthma exacerbations: Results from SARP-3

Journal article

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Quantitative CT metrics are associated with longitudinal lung function decline and future asthma exacerbations: Results from SARP-3

James G Krings, Charles W Goss, Daphne Lew, Maanasi Samant, Mary Clare McGregor, Jonathan Boomer, Leonard B Bacharier, Ajay Sheshadri, Chase Hall, Joshua Brownell, …

Journal of allergy and clinical immunology, Vol.148(3), pp.752-762

09/2021

DOI: 10.1016/j.jaci.2021.01.029

PMCID: PMC8349941

PMID: 33577895

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https://www.ncbi.nlm.nih.gov/pmc/articles/8349941View

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Abstract

Currently, there is limited knowledge regarding which imaging assessments of asthma are associated with accelerated longitudinal decline in lung function. We aimed to assess whether quantitative computed tomography (qCT) metrics are associated with longitudinal decline in lung function and morbidity in asthma. We analyzed 205 qCT scans of adult patients with asthma and calculated baseline markers of airway remodeling, lung density, and pointwise regional change in lung volume (Jacobian measures) for each participant. Using multivariable regression models, we then assessed the association of qCT measurements with the outcomes of future change in lung function, future exacerbation rate, and changes in validated measurements of morbidity. Greater baseline wall area percent (β = –0.15 [95% CI = –0.26 to –0.05]; P < .01), hyperinflation percent (β = –0.25 [95% CI = –0.41 to –0.09]; P < .01), and Jacobian gradient measurements (cranial-caudal β = 10.64 [95% CI = 3.79-17.49]; P < .01; posterior-anterior β = –9.14, [95% CI = –15.49 to –2.78]; P < .01) were associated with more severe future lung function decline. Additionally, greater wall area percent (rate ratio = 1.06 [95% CI = 1.01-1.10]; P = .02) and air trapping percent (rate ratio =1.01 [95% CI = 1.00-1.02]; P = .03), as well as lower decline in the Jacobian determinant mean (rate ratio = 0.58 [95% CI = 0.41-0.82]; P < .01) and Jacobian determinant standard deviation (rate ratio = 0.52 [95% CI = 0.32-0.85]; P = .01), were associated with a greater rate of future exacerbations. However, imaging metrics were not associated with clinically meaningful changes in scores on validated asthma morbidity questionnaires. Baseline qCT measures of more severe airway remodeling, more small airway disease and hyperinflation, and less pointwise regional change in lung volumes were associated with future lung function decline and asthma exacerbations.

Asthma

asthma exacerbations

asthma morbidity

CT imaging

longitudinal

lung function

severe asthma

Details

Title: Subtitle: Quantitative CT metrics are associated with longitudinal lung function decline and future asthma exacerbations: Results from SARP-3
Creators: James G Krings - Division of Pulmonary and Critical Care Medicine, Department of Medicine, St Louis, Mo.
Charles W Goss - Washington University in St. Louis
Daphne Lew - Washington University in St. Louis
Maanasi Samant - Division of Pulmonary and Critical Care Medicine, Department of Medicine, St Louis, Mo.
Mary Clare McGregor - Division of Pulmonary and Critical Care Medicine, Department of Medicine, St Louis, Mo.
Jonathan Boomer - University of Kansas
Leonard B Bacharier - Vanderbilt University
Ajay Sheshadri - The University of Texas MD Anderson Cancer Center
Chase Hall - University of Kansas
Joshua Brownell - University of Wisconsin–Madison
Ken B Schechtman - Washington University in St. Louis
Samuel Peterson - Vida Diagnostics (United States)
Stephen McEleney - Vida Diagnostics (United States)
David T Mauger - Pennsylvania State University
John V Fahy - University of California, San Francisco
Sean B Fain - University of Wisconsin–Madison
Loren C Denlinger - University of Wisconsin–Madison
Elliot Israel - Brigham and Women's Hospital
George Washko - Brigham and Women's Hospital
Eric Hoffman - University of Iowa
Sally E Wenzel - University of Pittsburgh
Mario Castro - University of Kansas
National Heart, Lung, and Blood Institute’s Severe Asthma Research Program Investigators
Resource Type: Journal article
Publication Details: Journal of allergy and clinical immunology, Vol.148(3), pp.752-762
DOI: 10.1016/j.jaci.2021.01.029
PMID: 33577895
PMCID: PMC8349941
NLM abbreviation: J Allergy Clin Immunol
ISSN: 0091-6749
eISSN: 1097-6825
Publisher: Elsevier Inc
Grant note: Washington University Institutional Training National Center for Advancing Translational Science National Heart, Lung, and Blood Institute National Heart, Lung, and Blood Institute to the Severe Asthma Research Program’s
Language: English
Date published: 09/2021
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Health, Sport, and Human Physiology ; Internal Medicine
Record Identifier: 9984275053202771

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