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. 2023 Jun 8;61(6):2300551.
doi: 10.1183/13993003.00551-2023. Print 2023 Jun.

Association of dysanapsis with mortality among older adults

Motahareh Vameghestahbanati  1 , Coralynn Sack  2 , Artur Wysoczanski  3 , Eric A Hoffman  4 , Elsa Angelini  3   5 , Norrina B Allen  6 , Alain G Bertoni  7 , Junfeng Guo  4 , David R Jacobs Jr  8 , Joel D Kaufman  2 , Andrew Laine  3 , Ching-Long Lin  4 , Daniel Malinsky  3 , Erin D Michos  9 , Elizabeth C Oelsner  3 , Steven J Shea  3 , Karol E Watson  10 , Andrea Benedetti  1 , R Graham Barr  3 , Benjamin M Smith  11   3
Affiliations

Association of dysanapsis with mortality among older adults

Motahareh Vameghestahbanati et al. Eur Respir J. .

Abstract

Dysanapsis – an anthropometric mismatch between airway tree calibre and lung size that is common in the general population – is strongly associated with all-cause mortality and increases susceptibility to tobacco smoking-related diseases https://bit.ly/42oDe8J

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Conflict of interest statement

Conflict of interest: C. Sack reports grants from NIEHS K23ES030725-04, outside the submitted work. E.A. Hoffman reports support for the present manuscript from NIH; E.A. Hoffman also reports that he is founder and shareholder of VIDA Diagnostics, and an unpaid member of Photon Counting CT advisory board for Siemens Healthineers, outside the submitted work. N.B. Allen reports support for the present manuscript from NIH/NHLBI; N.B. Allen also reports grants from NIH/NHLBI, outside the submitted work. J. Guo reports support for the present manuscript from National Institutes of Health; J. Guo also reports being a shareholder of VIDA Diagnostics, outside the submitted work. E.D. Michos reports advisory board participation with AstraZeneca, Bayer, Boehringer Ingelheim, Esperion, Novartis, Novo Nordisk and Pfizer, outside the submitted work. S.J. Shea reports support for the present manuscript from the National Heart, Lung, and Blood Institute. R.G. Barr reports support for the present manuscript from NIH, COPD Foundation and Foundation for the NIH; R.G. Barr also reports grants from American Lung Association, and advisory board participation with COPD Foundation, outside the submitted work. B.M. Smith reports support for the present manuscript from NIH, Canadian Lung Association, CIHR and Quebec Health Research Fund. All other authors have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Association of computed tomography (CT)-assessed dysanapsis with mortality. Kaplan–Meier survival curves for a) all-cause mortality and b–d) cause-specific mortality by quartile of airway-to-lung ratiocardiacCT (calculated as the mean of airway lumen diameters (in cm) divided by the cube-root of total lung volume (in cm3) estimated from cardiac CT; black: quartile 1, smallest; red: quartile 2; green: quartile 3; blue: quartile 4, largest). Likelihood ratio test p<0.001 for each panel. The adjusted 10-year hazard ratios and excess death rates per 10 000 person-years were calculated using proportional hazard and Poisson regression models, respectively, adjusting for baseline age, age2, sex, height, body mass index (BMI), BMI2, race/ethnicity, principal components of genetic ancestry, health insurance status, educational attainment, study site, baseline cigarette smoking status, pack-years, pack-years2, cigar smoking status, cigar-years, pipe smoking status, pipe-years, environmental tobacco smoke exposure status, environmental tobacco smoke exposure (hours per week), environmental tobacco smoke exposure (hours per week)2, 1-year residential outdoor air pollutant concentrations (particulate matter with aerodynamic diameter <2.5 μm, oxides of nitrogen and ozone), physician diagnosis of asthma, spatial location of airways proportion sampled from core versus peel, left versus right, and upper versus mid versus lower lung zones and number of airways measured and voxel size. Cause-specific death was defined by the primary (underlying) International Classification of Diseases code listed as underlying cause of death (atherosclerotic cardiovascular disease: I21–25, I63, I65–66, I69.3, F01, I70–72, I74–75; lung cancer: C33–34; COPD: J41–44).
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