Radiographic lung volumes predict progression to COPD in smokers with preserved spirometry in SPIROMICS

Mehrdad Arjomandi; Siyang Zeng; Igor Barjaktarevic; R. Graham Barr; Eugene R. Bleecker; Russell P. Bowler; Russell G. Buhr; Gerard J. Criner; Alejandro P. Comellas; Christopher B. Cooper; David J. Couper; Jeffrey L. Curtis; Mark T. Dransfield; MeiLan K. Han; Nadia N. Hansel; Eric A. Hoffman; Robert J. Kaner; Richard E. Kanner; Jerry A. Krishnan; Robert Paine; Stephen P. Peters; Stephen Rennard; Prescott G. Woodruff; SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) Investigators

doi:10.1183/13993003.02214-2018

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Radiographic lung volumes predict progression to COPD in smokers with preserved spirometry in SPIROMICS

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Radiographic lung volumes predict progression to COPD in smokers with preserved spirometry in SPIROMICS

Mehrdad Arjomandi, Siyang Zeng, Igor Barjaktarevic, R. Graham Barr, Eugene R. Bleecker, Russell P. Bowler, Russell G. Buhr, Gerard J. Criner, Alejandro P. Comellas, Christopher B. Cooper, …

The European respiratory journal, Vol.54(4), p.1802214

10/01/2019

DOI: 10.1183/13993003.02214-2018

PMCID: PMC7089627

PMID: 31439683

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Abstract

The characteristics that predict progression to overt chronic obstructive pulmonary disease (COPD) in smokers without spirometric airflow obstruction are not clearly defined. We conducted a post hoc analysis of 849 current and former smokers (>= 20 pack-years) with preserved spirometry from the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) cohort who had baseline computed tomography (CT) scans of lungs and serial spirometry. We examined whether CT-derived lung volumes representing air trapping could predict adverse respiratory outcomes and more rapid decline in spirometry to overt COPD using mixed-effect linear modelling. Among these subjects with normal forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio, CT-measured residual volume (RVCT) to total lung capacity (TLCCT) ratio varied widely, from 21% to 59%. Over 2.5 +/- 0.7 years of follow-up, subjects with higher RVCT/TLCCT had a greater differential rate of decline in FEV1/FVC; those in the upper RVCT/TLCCT tertile had a 0.66% (95% CI 0.06%-1.27%) faster rate of decline per year compared with those in the lower tertile (p=0.015) regardless of demographics, baseline spirometry, respiratory symptoms score, smoking status (former versus current) or smoking burden (pack-years). Accordingly, subjects with higher RVCT/TLCCT were more likely to develop spirometric COPD (OR 5.7 (95% CI 2.4-13.2) in upper versus lower RVCT/TLCCT tertile; p<0.001). Other CT indices of air trapping showed similar patterns of association with lung function decline; however, when all CT indices of air trapping, emphysema, and airway disease were included in the same model, only RVCT/TLCCT retained its significance. Increased air trapping based on radiographic lung volumes predicts accelerated spirometry decline and progression to COPD in smokers without obstruction.

Respiratory System

Life Sciences & Biomedicine

Science & Technology

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Title: Subtitle: Radiographic lung volumes predict progression to COPD in smokers with preserved spirometry in SPIROMICS
Creators: Mehrdad Arjomandi - University of California, San Francisco
Siyang Zeng - University of California, San Francisco
Igor Barjaktarevic - University of California, Los Angeles
R. Graham Barr - NewYork–Presbyterian Hospital
Eugene R. Bleecker - University of Arizona
Russell P. Bowler - National Jewish Health
Russell G. Buhr - University of California, Los Angeles
Gerard J. Criner - Temple University
Alejandro P. Comellas - University of Iowa
Christopher B. Cooper - University of California, Los Angeles
David J. Couper - University of North Carolina at Chapel Hill
Jeffrey L. Curtis - University of Michigan–Ann Arbor
Mark T. Dransfield - University of Alabama at Birmingham
MeiLan K. Han - University of Michigan
Nadia N. Hansel - Johns Hopkins University
Eric A. Hoffman - University of Iowa
Robert J. Kaner - Cornell University
Richard E. Kanner - University of Utah
Jerry A. Krishnan - University of Illinois Chicago
Robert Paine - University of Utah
Stephen P. Peters - Wake Forest University
Stephen Rennard - AstraZeneca (Brazil)
Prescott G. Woodruff - University of California, San Francisco
SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) Investigators
Resource Type: Journal article
Publication Details: The European respiratory journal, Vol.54(4), p.1802214
DOI: 10.1183/13993003.02214-2018
PMID: 31439683
PMCID: PMC7089627
NLM abbreviation: Eur Respir J
ISSN: 0903-1936
eISSN: 1399-3003
Publisher: European Respiratory Soc Journals Ltd
Number of pages: 15
Grant note: Flight Attendant Medical Research Institute HHSN268200900013C; HHSN268200900014C; HHSN268200900015C; HHSN268200900016C; HHSN268200900017C; HHSN268200900018C; HHSN268200900019C; HHSN268200900020C / NIH/NHLBI; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI)
Language: English
Date published: 10/01/2019
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
Record Identifier: 9984318783402771

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