| Association Between Airway Caliber Changes With Lung Inflation And Emphysema Assessed By Volumetric CT In Subjects With COPD. | |
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MedLine Citation:
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PMID: 21940776 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Abstract BACKGROUND:An increase in airway caliber (airway distensibility) with lung inflation is attenuated in COPD. Furthermore, some subjects have a decrease in airway caliber with lung inflation. We aimed to test the hypothesis that airway caliber increases are lower in subjects with emphysema-predominant (EP) compared to airway-predominant (AP) CT subtypes. Additionally, we compared clinical and CT features of subjects with (airway constrictors) and without a decrease in airway caliber. METHODS:Based on GOLD stages and CT subtypes, we created a control group (N=46) and matched COPD groups (N=23 each): GOLD-2-AP, GOLD-2-EP, GOLD-4-AP, and GOLD-4-EP. In the CT scans of all 138 subjects we measured emphysema, lung volumes, and caliber changes in the 3(rd) and 4(th) airway generations of two bronchi. We expressed airway distensibility (ratio of airway lumen diameter change to lung volume change from end tidal breathing to full inspiration) as a global or lobar measure based on normalization by whole-lung or lobar volume changes. RESULTS:Global distensibility in the 3(rd) and 4(th) airway generations was significantly lower in EP groups in GOLD-2 and GOLD-4 stages than controls. In GOLD-2 subjects, lobar distensibility of the right upper lobe 4(th) airway generation was significantly lower in those with EP than AP. In multivariate analysis, emphysema was an independent determinant of global and lobar airway distensibility. Compared to non-constrictors, airway constrictors experienced more dyspnea, were more hyperinflated, and had higher percentage emphysema. CONCLUSION:Distensibility of large-to-medium sized airways is reduced in subjects with an emphysema-predominant CT subtype. Emphysema seems to alter airway-parenchyma interdependence. (ClinicalTrials.gov Number NCT00608764). |
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Authors:
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Alejandro A Diaz; Carolyn E Come; James C Ross; Raúl San José Estépar; Meilan K Han; Stephen H Loring; Edwin K Silverman; George R Washko; |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-9-22 |
Journal Detail:
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Title: Chest Volume: - ISSN: 1931-3543 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-9-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston MA; |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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