Journal article
Structural airway imaging metrics are differentially associated with persistent chronic bronchitis
Thorax, Vol.76(4), pp.343-349
04/01/2021
DOI: 10.1136/thoraxjnl-2020-215853
PMCID: PMC8225550
PMID: 33408194
Abstract
Background
Chronic bronchitis (CB) is strongly associated with cigarette smoking, but not all smokers develop CB. We aimed to evaluate whether measures of structural airway disease on CT are differentially associated with CB.
Methods
In smokers between ages 45 and 80 years, and with Global Initiative for Obstructive Lung Disease stages 0-4, CB was defined by the classic definition. Airway disease on CT was quantified by (i) wall area percent (WA%) of segmental airways; (ii) Pi10, the square root of the wall area of a hypothetical airway with 10 mm internal perimeter; (iii) total airway count (TAC) and (iv) airway fractal dimension (AFD), a measure of the complex branching pattern and remodelling of airways. CB was also assessed at the 5-year follow-up visit.
Measurements and main results
Of 8917 participants, 1734 (19.4%) had CB at baseline. Airway measures were significantly worse in those with CB compared with those without CB: WA% 54.5 (8.8) versus 49.8 (8.3); Pi10 2.58 (0.67) versus 2.28 (0.59) mm; TAC 156.7 (81.6) versus 177.8 (91.1); AFD 1.477 (0.091) versus 1.497 (0.092) (all p<0.001). On follow-up of 5517 participants at 5 years, 399 (7.2%) had persistent CB. With adjustment for between-visits changes in smoking status and lung function, greater WA% and Pi10 were associated with significantly associated with persistent CB, adjusted OR per SD change 1.75, 95% CI 1.56 to 1.97; p<0.001 and 1.66, 95% CI 1.42 to 1.86; p<0.001, respectively. Higher AFD and TAC were associated with significantly lower odds of persistent CB, adjusted OR per SD change 0.76, 95% CI 0.67 to 0.86; p<0.001 and 0.69, 95% CI 0.60 to 0.80; p<0.001, respectively.
Conclusions
Higher baseline AFD and TAC are associated with a lower risk of persistent CB, irrespective of changes in smoking status, suggesting preserved airway structure can confer a reserve against CB.
Details
- Title: Subtitle
- Structural airway imaging metrics are differentially associated with persistent chronic bronchitis
- Creators
- Surya P. Bhatt - University of Alabama at BirminghamSandeep Bodduluri - University of Alabama at BirminghamAbhilash S. Kizhakke Puliyakote - Univ Calif San Diego Hlth Sci, La Jolla, CA USAElizabeth C. Oelsner - Columbia UniversityArie Nakhmani - University of Alabama at BirminghamDavid A. Lynch - National Jewish HealthCarla G. Wilson - National Jewish HealthSpyridon Fortis - University of Iowa Hospitals and ClinicsVictor Kim - Temple University
- Resource Type
- Journal article
- Publication Details
- Thorax, Vol.76(4), pp.343-349
- DOI
- 10.1136/thoraxjnl-2020-215853
- PMID
- 33408194
- PMCID
- PMC8225550
- NLM abbreviation
- Thorax
- ISSN
- 0040-6376
- eISSN
- 1468-3296
- Publisher
- Bmj Publishing Group
- Number of pages
- 7
- Grant note
- R21EB027891 / NIBIB; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Biomedical Imaging & Bioengineering (NIBIB) COPD Foundation 14380 / Department of Veterans Affairs; US Department of Veterans Affairs U01 HL089897; U01 HL089856 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA R01 HL151421; K23HL133438 / 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
- 04/01/2021
- Academic Unit
- Radiology; Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984359941502771
Metrics
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