CT-quantified emphysema in male heavy smokers: association with lung function decline

Firdaus A A Mohamed Hoesein, Bartjan de Hoop, Pieter Zanen, Hester Gietema, Cas L J J Kruitwagen, Bram van Ginneken, Ivana Isgum, Christian Mol, Rob J van Klaveren, Akkelies E Dijkstra, Hendricus Groen, Hendrika Boezen, Dirkje S Postma, Mathias Prokop, Jan-Willem J Lammers

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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 (FEV(1)) 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 FEV(1) 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.

Original languageEnglish
Pages (from-to)782-787
Number of pages6
JournalThorax
Volume66
Issue number9
DOIs
Publication statusPublished - Sep-2011

Keywords

  • OBSTRUCTIVE PULMONARY-DISEASE
  • QUANTITATIVE COMPUTED-TOMOGRAPHY
  • AIR-FLOW OBSTRUCTION
  • ANTITRYPSIN DEFICIENCY
  • SMOKING
  • DENSITOMETRY
  • PROGRESSION
  • MANAGEMENT
  • TRIAL
  • SEX

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