Vessel and Airway Characteristics in One-Year CT-defined Rapid Emphysema Progression : SPIROMICS
Rationale: Rates of emphysema progression vary in chronic obstructive pulmonary disease (COPD), and the relationship with vascular and airway pathophysiology remain unclear. Objective: 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. Methods: 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 ΔEI>1%), non-progressors (NP, n=301; 1-year ΔEI±0.5%) 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. Results: 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. Conclusion: 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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Annals of the American Thoracic Society - (2024) vom: 26. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gerard, Sarah E [VerfasserIn] |
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Date Revised 27.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1513/AnnalsATS.202304-383OC |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370196082 |
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| 100 | 1 | |a Gerard, Sarah E |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Vessel and Airway Characteristics in One-Year CT-defined Rapid Emphysema Progression |b SPIROMICS |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 27.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Rationale: Rates of emphysema progression vary in chronic obstructive pulmonary disease (COPD), and the relationship with vascular and airway pathophysiology remain unclear. Objective: 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. Methods: 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 ΔEI>1%), non-progressors (NP, n=301; 1-year ΔEI±0.5%) 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. Results: 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. Conclusion: 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 | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Dougherty, Timothy M |e verfasserin |4 aut | |
| 700 | 1 | |a Nagpal, Prashant |e verfasserin |4 aut | |
| 700 | 1 | |a Jin, Dakai |e verfasserin |4 aut | |
| 700 | 1 | |a Han, MeiLan K |e verfasserin |4 aut | |
| 700 | 1 | |a Newell, John D |c Jr |e verfasserin |4 aut | |
| 700 | 1 | |a Saha, Punam K |e verfasserin |4 aut | |
| 700 | 1 | |a Comellas, Alejandro P |e verfasserin |4 aut | |
| 700 | 1 | |a Cooper, Christopher B |e verfasserin |4 aut | |
| 700 | 1 | |a Couper, David |e verfasserin |4 aut | |
| 700 | 1 | |a Fortis, Spyridon |e verfasserin |4 aut | |
| 700 | 1 | |a Guo, Junfeng |e verfasserin |4 aut | |
| 700 | 1 | |a Hansel, Nadia N |e verfasserin |4 aut | |
| 700 | 1 | |a Kanner, Richard E |e verfasserin |4 aut | |
| 700 | 1 | |a Kazeroni, Ella A |e verfasserin |4 aut | |
| 700 | 1 | |a Martinez, Fernando J |e verfasserin |4 aut | |
| 700 | 1 | |a Motahari, Amin |e verfasserin |4 aut | |
| 700 | 1 | |a Paine Iii, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Rennard, Stephen |e verfasserin |4 aut | |
| 700 | 1 | |a Schroeder, Joyce D |e verfasserin |4 aut | |
| 700 | 1 | |a Woodruff, Prescott G |e verfasserin |4 aut | |
| 700 | 1 | |a Barr, R Graham |e verfasserin |4 aut | |
| 700 | 1 | |a Smith, Benjamin M |e verfasserin |4 aut | |
| 700 | 1 | |a Hoffman, Eric A |e verfasserin |4 aut | |
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