TY - JOUR
T1 - CT-quantified emphysema in male heavy smokers: Association with lung function decline
AU - Mohamed Hoesein, Firdaus A. A.
AU - de Hoop, Bartjan
AU - Zanen, Pieter
AU - Gietema, Hester
AU - Kruitwagen, Cas L. J. J.
AU - van Ginneken, Bram
AU - Isgum, Ivana
AU - Mol, Christian
AU - van Klaveren, Rob J.
AU - Dijkstra, Akkelies E.
AU - Groen, Harry J. M.
AU - Boezen, H. Marike
AU - Postma, Dirkje S.
AU - Prokop, Mathias
AU - Lammers, Jan-Willem J.
PY - 2011
Y1 - 2011
N2 - Background: Emphysema and small airway disease both contribute to chronic obstructive pulmonary disease (COPD), a disease characterised by accelerated decline in lung function. The association between the extent of emphysema in male current and former smokers and lung function decline was investigated. Methods: Current and former heavy smokers participating in a lung cancer screening trial were recruited to the study and all underwent CT. Spirometry was performed at baseline and at 3-year follow-up. The 15th percentile (Perc15) was used to assess the severity of emphysema. Results: 2085 men of mean age 59.8 years participated in the study. Mean (SD) baseline Perc15 was -934.9 (19.5) HU. A lower Perc15 value correlated with a lower forced expiratory volume in 1 s (FEV1) at baseline (r=0.12, p<0.001). Linear mixed model analysis showed that a lower Perc15 was significantly related to a greater decline in FEV1 after follow-up (p<0.001). Participants without baseline airway obstruction who developed it after follow-up had significantly lower mean (SD) Perc15 values at baseline than those who did not develop obstruction (-934.2 (17.1) HU vs -930.2 (19.7) HU, p<0.001). Conclusion: Greater baseline severity of CT-detected emphysema is related to lower baseline lung function and greater rates of lung function decline, even in those without airway obstruction. CT-detected emphysema aids in identifying non-obstructed male smokers who will develop airflow obstruction.
AB - Background: Emphysema and small airway disease both contribute to chronic obstructive pulmonary disease (COPD), a disease characterised by accelerated decline in lung function. The association between the extent of emphysema in male current and former smokers and lung function decline was investigated. Methods: Current and former heavy smokers participating in a lung cancer screening trial were recruited to the study and all underwent CT. Spirometry was performed at baseline and at 3-year follow-up. The 15th percentile (Perc15) was used to assess the severity of emphysema. Results: 2085 men of mean age 59.8 years participated in the study. Mean (SD) baseline Perc15 was -934.9 (19.5) HU. A lower Perc15 value correlated with a lower forced expiratory volume in 1 s (FEV1) at baseline (r=0.12, p<0.001). Linear mixed model analysis showed that a lower Perc15 was significantly related to a greater decline in FEV1 after follow-up (p<0.001). Participants without baseline airway obstruction who developed it after follow-up had significantly lower mean (SD) Perc15 values at baseline than those who did not develop obstruction (-934.2 (17.1) HU vs -930.2 (19.7) HU, p<0.001). Conclusion: Greater baseline severity of CT-detected emphysema is related to lower baseline lung function and greater rates of lung function decline, even in those without airway obstruction. CT-detected emphysema aids in identifying non-obstructed male smokers who will develop airflow obstruction.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=80051911775&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/21474499
U2 - https://doi.org/10.1136/thx.2010.145995
DO - https://doi.org/10.1136/thx.2010.145995
M3 - Article
C2 - 21474499
SN - 0040-6376
VL - 66
SP - 782
EP - 787
JO - Thorax
JF - Thorax
IS - 9
ER -