CT-quantified emphysema in male heavy smokers: association with lung function decline. Issue 9 (7th April 2011)

• Record Type: Journal Article
• Authors: Mohamed Hoesein, Firdaus A A; de Hoop, Bartjan; Zanen, Pieter; Gietema, Hester; Kruitwagen, Cas L J J; van Ginneken, Bram; Isgum, Ivana; Mol, Christian; van Klaveren, Rob J; Dijkstra, Akkelies E; Groen, Harry J M; Boezen, H Marike; Postma, Dirkje S; Prokop, Mathias; Lammers, Jan-Willem J
• Is Part Of: Thorax. Volume 66:Issue 9(2011)
• Page Start: 782
• Page End: 787
• Publication Date: 2011-04-07
• Subjects: CT -- chronic obstructive pulmonary disease -- emphysema -- lung function -- spirometry -- COPD epidemiology -- imaging/CT MRI etc; Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thx.2010.145995
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : 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.