Journal article
Regional distribution of high-attenuation areas on chest computed tomography in the Multi-Ethnic Study of Atherosclerosis
ERJ open research, Vol.6(1), 00115-2019
01/01/2020
DOI: 10.1183/23120541.00115-2019
PMCID: PMC7049731
PMID: 32154292
Abstract
High-attenuation areas (HAA) are a computed tomography-based quantitative measure of subclinical interstitial lung disease (ILD). We aimed to validate HAA in lung regions that are less subject to artefacts, such as extravascular lung water or dependent atelectasis. We examined the associations of HAA within six lung regions (basilar, non-basilar, peel, core, basilar peel, basilar core) with serum biomarkers of lung remodelling, forced vital capacity (FVC), visually-assessed interstitial lung abnormalities (ILA), and all-cause and ILD-specific mortality.
We performed cross-sectional and longitudinal analyses of participants in the Multi-Ethnic Study of Atherosclerosis, a prospective cohort of 6814 adults aged 45-84 years without known cardiovascular disease who underwent cardiac computed tomography.
Median regional HAA ranged from 3.8% in the peel to 4.8% in the basilar core. Doubling of regional HAA was associated with greater serum matrix metalloproteinase-7 (range 3.8% to 10.3%; p <= 0.01), higher odds of ILA (OR 1.42 to 2.20; p <= 0.03), and a higher risk of all-cause mortality (hazard ratio 1.20 to 1.47; p <= 0.001). Doubling of regional HAA was associated with greater serum interleukin-6 (4.9% to 10.3%; p <= 0.005) and higher risk of ILD-specific mortality (hazard ratio 3.30 to 3.98; p<0.001), except in the basilar core. Doubling of regional HAA was associated with lower FVC in the non-basilar, core and basilar core (113 mL to 186 mL; p<0.001).
Associations of HAA with lung remodelling biomarkers, ILA risk and all-cause mortality were consistent across all regions of the lung, including dependent areas where atelectasis may be present. These findings support the validity of HAA as a measure of pathologic subclinical ILD.
Details
- Title: Subtitle
- Regional distribution of high-attenuation areas on chest computed tomography in the Multi-Ethnic Study of Atherosclerosis
- Creators
- Bina Choi - Columbia University Medical CenterSteven M. Kawut - University of PennsylvaniaGanesh Raghu - University of Washington Medical CenterEric Hoffman - Roy J. and Lucille A. Carver College of MedicineRussell Tracy - University of VermontPurnema Madahar - Columbia University Medical CenterElana J. Bernstein - Columbia University Medical CenterR. Graham Barr - Columbia University Irving Medical CenterDavid J. Lederer - Columbia University Medical CenterAnna Podolanczuk - Columbia University Medical Center
- Resource Type
- Journal article
- Publication Details
- ERJ open research, Vol.6(1), 00115-2019
- DOI
- 10.1183/23120541.00115-2019
- PMID
- 32154292
- PMCID
- PMC7049731
- NLM abbreviation
- ERJ Open Res
- ISSN
- 2312-0541
- eISSN
- 2312-0541
- Publisher
- European Respiratory Soc Journals Ltd
- Number of pages
- 9
- Grant note
- HHSN268201500003I; N01-HC-95159-N01-HC-95169; UL1-TR-000040; UL1-TR-001079; R01-HL077612; RC1-HL100543; R01-HL-103676; K24-HL-131937; K24-HL103844; K23AR075112; K23-HL140199 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Language
- English
- Date published
- 01/01/2020
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
- Record Identifier
- 9984318719102771
Metrics
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