1. Relationship between quantitative CT metrics and health status and BODE in chronic obstructive pulmonary disease
- Author
-
James Murphy, Edwin J. R. van Beek, Eugene Berkowitz, Carlos Orozco, Venkata Bandi, Robert M. Steiner, Shivam Chandan, Stephanie A. Santorico, Joel L. Weissfeld, Kalpalatha K. Guntupalli, Matthew J. Budoff, Robert H. Brown, Charles Trinh, Ya Hong Chen, Phillip M. Westgate, John D. Newell, Gloria Westney, Raúl San José Estépar, Russell P. Bowler, Geoffrey McLennan, Robert A. Wise, Ella A. Kazerooni, Nathaniel Marchetti, John H. M. Austin, Harvey O. Coxson, Douglas Everett, Joseph H. Tashjian, Antonio Anzueto, Joe Piccoli, Homayoon Farzadegan, Richard Casaburi, Michael H. Cho, Philip Alapat, Charlene McEvoy, Sandra G. Adams, Marilyn G. Foreman, R. Graham Barr, Jessica Bon, Fernando J. Martinez, Susan Murray, Nadia N. Hansel, Paul J. Friedman, Francine L. Jacobson, Ruthie Knowles, Verity McArthur, Jennifer L. Black-Shinn, Joe W. Ramsdell, Janos Porszasz, Martina Wamboldt, Chandra Dass, Terri H. Beaty, John J. Reilly, Timothy Bresnahan, Hans Fischer, Jordan A. Zach, Victor Kim, Jacqueline B. Hetmanski, Elizabeth Guy, Dzimitry Kazlouski, Stacey Meyerer, Eric A. Hoffman, Philip F. Judy, Sarah Moyle, Adam L. Friedlander, Frank C. Sciurba, Brad H. Thompson, Mark T. Dransfield, Tanda Murray, Michael E. DeBakey, Margaret Forbes, Nicola A. Hanania, Gregory L. Kinney, Barbara J. Klanderman, Mustafa A. Atik, Gerard J. Criner, Christine H. Wendt, Dwight C. Look, James D. Crapo, Elizabeth A. Regan, Hirani Kamal, Andrew Allen, Anastasia Rodionova, Amber Powell, Heather Baumhauer, Quentin Anderson, Aditi Satti, Dennis E. Niewoehner, John E. Hokanson, Marci K. Sontag, William C. Bailey, Lyrica X. Liu, Hrudaya Nath, Neil R. MacIntyre, David A. Lynch, Kathryn L. Rice, Samantha Bragan, Barry J. Make, Byron Thomashow, Douglas Stinson, Jered Sieren, Richard Rosiello, Roham Darvishi, Robert L. Jensen, Tanya Mann, Lacey Washington, Gregory B. Diette, Christoph Lange, Mario E. Ruiz, Jeffrey L. Curtis, Joyce D. Schroeder, Antara Mallampalli, Tadashi Allen, Rebecca Leek, Nan M. Laird, Craig P. Hersh, George R. Washko, H. Page McAdams, Amir Sharafkhaneh, Alex Kluiber, MeiLan K. Han, Carl R. Fuhrman, A. James Mamary, Carla Wilson, James C. Ross, Carlos H. Martinez, Edwin K. Silverman, Dawn L. DeMeo, and Maura Robinson
- Subjects
Male ,Pulmonary and Respiratory Medicine ,Spirometry ,medicine.medical_specialty ,Health Status ,Body Mass Index ,Pulmonary Disease, Chronic Obstructive ,Surveys and Questionnaires ,Internal medicine ,Hounsfield scale ,medicine ,Humans ,Lung emphysema ,Lung ,Aged ,Aged, 80 and over ,Emphysema ,COPD ,medicine.diagnostic_test ,business.industry ,Middle Aged ,respiratory system ,medicine.disease ,humanities ,Obstructive lung disease ,respiratory tract diseases ,Dyspnea ,medicine.anatomical_structure ,Multivariate Analysis ,Cardiology ,Physical therapy ,Regression Analysis ,Female ,Tomography, X-Ray Computed ,Airway ,business ,Body mass index - Abstract
The value of quantitative CT (QCT) to identify chronic obstructive pulmonary disease (COPD) phenotypes is increasingly appreciated. The authors hypothesised that QCT-defined emphysema and airway abnormalities relate to St George's Respiratory Questionnaire (SGRQ) and Body-Mass Index, Airflow Obstruction, Dyspnea and Exercise Capacity Index (BODE).1200 COPDGene subjects meeting Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria for COPD with QCT analysis were included. Total lung emphysema was measured using the density mask technique with a -950 Hounsfield unit threshold. An automated programme measured mean wall thickness (WT), wall area percentage (WA%) and 10 mm lumenal perimeter (pi10) in six segmental bronchi. Separate multivariate analyses examined the relative influence of airway measures and emphysema on SGRQ and BODE.In separate models predicting SGRQ score, a 1 unit SD increase in each airway measure predicted higher SGRQ scores (for WT, 1.90 points higher, p=0.002; for WA%, 1.52 points higher, p=0.02; for pi10, 2.83 points higher p0.001). The comparable increase in SGRQ for a 1 unit SD increase in emphysema percentage in these models was relatively weaker, significant only in the pi10 model (for emphysema percentage, 1.45 points higher, p=0.01). In separate models predicting BODE, a 1 unit SD increase in each airway measure predicted higher BODE scores (for WT, 1.07-fold increase, p0.001; for WA%, 1.20-fold increase, p0.001; for pi10, 1.16-fold increase, p0.001). In these models, emphysema more strongly influenced BODE (range 1.24-1.26-fold increase, p0.001).Emphysema and airway disease both relate to clinically important parameters. The relative influence of airway disease is greater for SGRQ; the relative influence of emphysema is greater for BODE.
- Published
- 2012