Associations between emphysema-like lung on CT and incident airflow limitation: a general population-based cohort study

doi:10.1136/thoraxjnl-2017-210842

. 2018 May;73(5):486-488.

doi: 10.1136/thoraxjnl-2017-210842. Epub 2017 Oct 26.

Associations between emphysema-like lung on CT and incident airflow limitation: a general population-based cohort study

Elizabeth C Oelsner^{1

2}, Benjamin M Smith^{1

3}, Eric A Hoffman⁴, Aaron R Folsom⁵, Steven M Kawut⁶, Joel D Kaufman⁷, Ani Manichaikul⁸, David J Lederer¹, Joseph E Schwartz¹, Karol E Watson⁹, Paul L Enright¹⁰, John H M Austin¹, Joao A C Lima¹¹, Steven J Shea^{1

2}, Robert G Barr^{1

2}

Affiliations

¹ Department of Medicine, Columbia University College of Physicians and Surgeons, New York City, New York, USA.
² Department of Epidemiology, Columbia University Mailman School of Public Health, New York City, New York, USA.
³ Respiratory Division, McGill University, Montreal, Quebec, Canada.
⁴ Department of Radiology, University of Iowa, Iowa City, Iowa, USA.
⁵ Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA.
⁶ School of Medicine, Pulmonary, Allergy and Critical Care Division, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁷ Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA.
⁸ Department of Public Health Sciences, Division of Biostatistics and Epidemiology, University of Virginia, Charlottesville, Virginia, USA.
⁹ Division of Cardiology, UCLA School of Medicine, Los Angeles, California, USA.
¹⁰ Department of Medicine, University of Arizona, Tucson, Arizona, USA.
¹¹ Department of Cardiology, Johns Hopkins University, Baltimore, Maryland, USA.

PMID: 29074811
PMCID: PMC5903958
DOI: 10.1136/thoraxjnl-2017-210842

Associations between emphysema-like lung on CT and incident airflow limitation: a general population-based cohort study

Elizabeth C Oelsner et al. Thorax. 2018 May.

. 2018 May;73(5):486-488.

doi: 10.1136/thoraxjnl-2017-210842. Epub 2017 Oct 26.

Authors

Affiliations

¹ Department of Medicine, Columbia University College of Physicians and Surgeons, New York City, New York, USA.
² Department of Epidemiology, Columbia University Mailman School of Public Health, New York City, New York, USA.
³ Respiratory Division, McGill University, Montreal, Quebec, Canada.
⁴ Department of Radiology, University of Iowa, Iowa City, Iowa, USA.
⁵ Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA.
⁶ School of Medicine, Pulmonary, Allergy and Critical Care Division, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁷ Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA.
⁸ Department of Public Health Sciences, Division of Biostatistics and Epidemiology, University of Virginia, Charlottesville, Virginia, USA.
⁹ Division of Cardiology, UCLA School of Medicine, Los Angeles, California, USA.
¹⁰ Department of Medicine, University of Arizona, Tucson, Arizona, USA.
¹¹ Department of Cardiology, Johns Hopkins University, Baltimore, Maryland, USA.

PMID: 29074811
PMCID: PMC5903958
DOI: 10.1136/thoraxjnl-2017-210842

Abstract

Emphysema on CT is associated with accelerated lung function decline in heavy smokers and patients with COPD; however, in the general population, it is not known whether greater emphysema-like lung on CT is associated with incident COPD. We used data from 2045 adult participants without initial prebronchodilator airflow limitation, classified by FEV₁/FVC<0.70, in the Multi-Ethnic Study of Atherosclerosis. Emphysema-like lung on baseline cardiac CT, defined as per cent low attenuation areas_<-950HU>upper limit of normal, was associated with increased odds of incident airflow limitation at 5-year follow-up on both prebronchodilator (adjusted OR 2.62, 95% CI 1.47 to 4.67) and postbronchodilator (adjusted OR 4.38, 95% CI 1.63 to 11.74) spirometry, independent of smoking history. These results support investigation into whether emphysema-like lung could be informative for COPD risk stratification.

Keywords: COPD epidemiology; emphysema; imaging/CT MRI.

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Conflict of interest statement

Competing interests: The authors do not report any competing interests, besides funding from the NIH, with the following exceptions: BMS reports training/salary awards from the Quebec Health Research Fund, and grants from McGill University; EAH is a founder and shareholder of VIDA Diagnostics, a company commercialising lung image analysis software developed, in part, at the University of Iowa; SMK has received non-financial support from the ATS, personal fees from the European Respiratory Journal for serving on an editorial board, and the University of Pennsylvania has received grants from Actelion, grants from United Therapeutics, grants from Gilead, grants from Lung Biotech, and grants from Bayer for CME courses; RGB reports grants from the Alpha-1 Foundation, COPD Foundation, and Foundation for the NIH, personal fees from UpToDate, and travel reimbursement from the COPD Foundation.

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References

1. Auerbach O, Hammond EC, Garfinkel L, et al. Relation of smoking and age to emphysema. Whole-lung section study. N Engl J Med. 1972;286(16):853–7. - PubMed
1. Gevenois PA, de Maertelaer V, De Vuyst P, et al. Comparison of computed density and macroscopic morphometry in pulmonary emphysema. Am J Respir Crit Care Med. 1995;152(2):653–7. - PubMed
1. Gevenois PA, De Vuyst P, de Maertelaer V, et al. Comparison of computed density and microscopic morphometry in pulmonary emphysema. Am J Respir Crit Care Med. 1996;154(1):187–92. - PubMed
1. Johannessen A, Skorge TD, Bottai M, et al. Mortality by level of emphysema and airway wall thickness. Am J Respir Crit Care Med. 2013;187(6):602–8. - PubMed
1. Oelsner EC, Hoffman EA, Folsom AR, et al. Association between emphysema-like lung on cardiac computed tomography and mortality in persons without airflow obstruction: a cohort study. Ann Int Med. 2014;161(12):863–73. - PMC - PubMed

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[1] Auerbach O, Hammond EC, Garfinkel L, et al. Relation of smoking and age to emphysema. Whole-lung section study. N Engl J Med. 1972;286(16):853–7. - PubMed

[2] Auerbach O, Hammond EC, Garfinkel L, et al. Relation of smoking and age to emphysema. Whole-lung section study. N Engl J Med. 1972;286(16):853–7. - PubMed

[3] Gevenois PA, de Maertelaer V, De Vuyst P, et al. Comparison of computed density and macroscopic morphometry in pulmonary emphysema. Am J Respir Crit Care Med. 1995;152(2):653–7. - PubMed

[4] Gevenois PA, de Maertelaer V, De Vuyst P, et al. Comparison of computed density and macroscopic morphometry in pulmonary emphysema. Am J Respir Crit Care Med. 1995;152(2):653–7. - PubMed

[5] Gevenois PA, De Vuyst P, de Maertelaer V, et al. Comparison of computed density and microscopic morphometry in pulmonary emphysema. Am J Respir Crit Care Med. 1996;154(1):187–92. - PubMed

[6] Gevenois PA, De Vuyst P, de Maertelaer V, et al. Comparison of computed density and microscopic morphometry in pulmonary emphysema. Am J Respir Crit Care Med. 1996;154(1):187–92. - PubMed

[7] Johannessen A, Skorge TD, Bottai M, et al. Mortality by level of emphysema and airway wall thickness. Am J Respir Crit Care Med. 2013;187(6):602–8. - PubMed

[8] Johannessen A, Skorge TD, Bottai M, et al. Mortality by level of emphysema and airway wall thickness. Am J Respir Crit Care Med. 2013;187(6):602–8. - PubMed

[9] Oelsner EC, Hoffman EA, Folsom AR, et al. Association between emphysema-like lung on cardiac computed tomography and mortality in persons without airflow obstruction: a cohort study. Ann Int Med. 2014;161(12):863–73. - PMC - PubMed

[10] Oelsner EC, Hoffman EA, Folsom AR, et al. Association between emphysema-like lung on cardiac computed tomography and mortality in persons without airflow obstruction: a cohort study. Ann Int Med. 2014;161(12):863–73. - PMC - PubMed

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Associations between emphysema-like lung on CT and incident airflow limitation: a general population-based cohort study

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Associations between emphysema-like lung on CT and incident airflow limitation: a general population-based cohort study

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