Journal article
Vessel and Airway Characteristics in One-Year CT-defined Rapid Emphysema Progression: SPIROMICS
Annals of the American Thoracic Society, Vol.21(7), pp.1022-1033
03/26/2024
DOI: 10.1513/AnnalsATS.202304-383OC
PMCID: PMC11284327
PMID: 38530051
Abstract
Rates of emphysema progression vary in chronic obstructive pulmonary disease (COPD), and the relationship with vascular and airway pathophysiology remain unclear.
We sought to determine if indices of peripheral (segmental and beyond) pulmonary arterial (PA) dilation measured via computed tomography (CT) are associated with a 1-year index of emphysema (EI: %voxels<-950HU) progression.
599 GOLD 0-3 former and never-smokers were evaluated from the SubPopulations and InterMediate Outcome Measures in COPD Study (SPIROMICS) cohort: rapid-emphysema-progressors (RP, n=188; 1-year EI>1%), non-progressors (NP, n=301; 1-year EI0.5%) and never-smokers (NS: N=110). Segmental PA cross-sectional areas were standardized to associated airway luminal areas (Segmental : Pulmonary Artery-to-Airway Ratio: PAARseg). Full inspiratory CT scan-derived total (arteries + veins) pulmonary vascular volume (TPVV) was compared to vessel volume with radius smaller than 0.75mm (SVV.75/TPVV). Airway-to-lung ratios (an index of dysanapsis and COPD risk) were compared to TPVV-lung-volume-ratios.
Compared with NP, RP exhibited significantly larger PAARseg (0.73±0.29 vs. 0.67±0.23; p=0.001), lower TPVV-to-lung-volume ratio (3.21%±0.42% vs. 3.48%±0.38%; p=5.0 x 10-12), lower airway-to-lung-volume ratio (0.031±0.003 vs. 0.034±0.004; p=6.1 x 10-13) and larger SVV.75/TPVV (37.91%±4.26% vs. 35.53±4.89; p=1.9 x 10-7). In adjusted analyses, a 1-SD increment in PAARseg was associated with a 98.4% higher rate of severe exacerbations (95%CI: 29 to 206%; p = 0.002) and 79.3% higher in odds of being in the rapid emphysema progression group (95%CI: 24% to 157%; p = 0.001). At year-2 followup, the CT-defined RP group demonstrated a significant decline in post-bronchodilator-FEV1% predicted.
Rapid one-year progression of emphysema was associated with indices indicative of higher peripheral pulmonary vascular resistance and a possible role played by pulmonary vascular-airway dysanapsis.
Details
- Title: Subtitle
- Vessel and Airway Characteristics in One-Year CT-defined Rapid Emphysema Progression: SPIROMICS
- Creators
- Sarah E Gerard - University of IowaTimothy M Dougherty - University of IowaPrashant Nagpal - University of IowaDakai Jin - University of Iowa, Electrical and Computer Engineering, Iowa City, Iowa, United StatesMeiLan K Han - University of MichiganJohn D Newell Jr - University of Iowa, Radiology, Iowa City, Iowa, United StatesPunam K Saha - University of IowaAlejandro P Comellas - United StatesChristopher B Cooper - Harbor–UCLA Medical CenterDavid Couper - University of North Carolina at Chapel HillSpyridon Fortis - University of Iowa Hospitals and Clinics, 21782, Division of Pulmonary, Critical Care and Occupation Medicine, Iowa City, Iowa, United StatesJunfeng Guo - University of IowaNadia N Hansel - Johns Hopkins UniversityRichard E Kanner - University of UtahElla A Kazeroni - University of MichiganFernando J Martinez - Weill Cornell MedicineAmin Motahari - University of IowaRobert Paine III - University of UtahStephen Rennard - University of Nebraska at OmahaPrescott G Woodruff - University of California, San FranciscoJoyce D Schroeder - University of Utah HospitalR Graham Barr - Columbia UniversityBenjamin M Smith - Columbia UniversityEric A Hoffman
- Resource Type
- Journal article
- Publication Details
- Annals of the American Thoracic Society, Vol.21(7), pp.1022-1033
- DOI
- 10.1513/AnnalsATS.202304-383OC
- PMID
- 38530051
- PMCID
- PMC11284327
- NLM abbreviation
- Ann Am Thorac Soc
- eISSN
- 2325-6621
- Language
- English
- Electronic publication date
- 03/26/2024
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
- Record Identifier
- 9984577154402771
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