CT Scan Findings of Emphysema Predict Mortality in COPD

Haruna, Akane; Muro, Shigeo; Nakano, Yasutaka; Ohara, Tadashi; Hoshino, Yuma; Ogawa, Emiko; Hirai, Toyohiro; Niimi, Akio; Nishimura, Koichi; Chin, Kazuo; Mishima, Michiaki

doi:10.1378/chest.09-2836

Cited by 243 publications

(199 citation statements)

References 33 publications

Supporting

Mentioning

179

Contrasting

Unclassified

Order By: Relevance

“…37,38 CT scanning has been shown to provide a valid measure of % emphysema in smokers 39 and patients with COPD 23,40 and is associated with respiratory symptoms 41 and clinical outcomes in smokers 42 and in patients with COPD. 43 Air trapping measured on expiration has been used in asthma studies to refl ect failure of the lung to empty and may refl ect the presence of small airways disease. 24,25 Several studies have shown that dynamic lung hyperinfl ation is associated with 6MWD and daily physical activity in COPD.…”

Section: Discussionmentioning

confidence: 99%

Six-Minute Walk Distance Predictors, Including CT Scan Measures, in the COPDGene Cohort

Rambod

Pórszász

Make

et al. 2012

Chest

View full text Add to dashboard Cite

Background: Exercise tolerance in COPD is only moderately well predicted by airfl ow obstruction assessed by FEV 1 . We determined whether other phenotypic characteristics, including CT scan measures, are independent predictors of 6-min walk distance (6MWD) in the COPDGene cohort. Methods: COPDGene recruits non-Hispanic Caucasian and African American current and ex-smokers. Phenotyping measures include postbronchodilator FEV 1 % predicted and inspiratory and expiratory CT lung scans. We defi ned % emphysema as the percentage of lung voxels , 2 950 Hounsfi eld units on the inspiratory scan and % gas trapping as the percentage of lung voxels , 2 856 Hounsfi eld units on the expiratory scan. Results: Data of the fi rst 2,500 participants of the COPDGene cohort were analyzed. Participant age was 61 Ϯ 9 years; 51% were men; 76% were non-Hispanic Caucasians, and 24% were African Americans. Fifty-six percent had spirometrically defi ned COPD, with 9.3%, 23.4%, 15.0%, and 8.3% in GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages I to IV, respectively. Higher % emphysema and % gas trapping predicted lower 6MWD ( P , .001). However, in a given spirometric group, after adjustment for age, sex, race, and BMI, neither % emphysema nor % gas trapping, or their interactions with FEV 1 % predicted, remained a signifi cant 6MWD predictor. In a given spirometric group, only 16% to 27% of the variance in 6MWD could be explained by age, male sex, Caucasian race, and lower BMI as signifi cant predictors of higher 6MWD. Conclusions:In this large cohort of smokers in a given spirometric stage, phenotypic characteristics were only modestly predictive of 6MWD. CT scan measures of emphysema and gas trapping were not predictive of 6MWD after adjustment for other phenotypic characteristics. CHEST 2012; 141(4):867 -875Abbreviations: 6MWD 5 6-min walk distance; 6MWT 5 6-min walk test; GOLD 5 Global Initiative for Chronic Obstructive Lung Disease; HU 5 Hounsfi eld unit; LOWESS 5 locally weighted scatterplot smoothing

show abstract

Section: Discussionmentioning

confidence: 99%

Six-Minute Walk Distance Predictors, Including CT Scan Measures, in the COPDGene Cohort

Rambod

Pórszász

Make

et al. 2012

Chest

View full text Add to dashboard Cite

show abstract

“…Subsequent studies 54,55 , with smaller cohorts but longer follow-up time (4 versus 8 years) and with different AL severity observed a significant association of lung attenuation areas low attenuation area (% LAA) and the prognosis of the disease 54,55 . Patient selection and emphysema evaluation criteria (% LAA) make comparisons between studies difficult.…”

Section: Emphysema and Mortalitymentioning

confidence: 97%

“…Haruna et al 54 demonstrated in a cohort of men with COPD that the ability of emphysema to predict mortality was independent of age, FEV 1 , and other predictors associated with the emphysema phenotype such as BMI, RV/TLC and the K co . However, important factors such as the BODE index and comorbidities were not included in the comparative analysis.…”

Section: Emphysema and Mortalitymentioning

confidence: 99%

The Impact of Emphysema on Chronic Obstructive Pulmonary Diseases

Torres¹,

Casanova²

2017

BRN

View full text Add to dashboard Cite

Emphysema is defined as an abnormal and permanent enlargement of the air spaces distal to the terminal bronchioles that is accompanied by destruction of the air space walls, with no obvious fibrosis (i.e. there is no fibrosis visible to the naked eye) and it is usually associated to tobacco smoking. Although it is included in the pathological definition of chronic obstructive pulmonary disease (COPD), not all COPD patients have emphysema and its impact on the clinical presentation and the natural history of the disease is variable. The present review will cover the prevalence of emphysema in COPD patients, its impact on the clinical presentation, association with comorbidities and the main outcomes of the disease: exacerbations, lung function decline and mortality. In this review, we will only evaluate the relationship of tobacco-related emphysema with COPD. (BRN Rev. 2017;3:235-46)

show abstract

“…In patients with α1-antitrypsin deficiency, density-based emphysema measurement has shown a superior accuracy in detecting worsening of emphysema, and therefore has been accepted as the effective diagnostic method for detecting disease progression (16). The CT density mask method was found to have an association with COPD mortality, and is reported to be a stronger predictive parameter for cardiac and respiratory mortality than global initiative for chronic obstructive lung disease (GOLD) staging (17,18). Patients with greater quantitative measures of emphysema were reported to have more rapid decline of PFT parameters (19).…”

Section: Emphysema Quantificationmentioning

confidence: 99%

Quantitative CT Imaging in Chronic Obstructive Pulmonary Disease: Review of Current Status and Future Challenges

Cho

Seo

Lee

et al. 2018

J Korean Soc Radiol

View full text Add to dashboard Cite

Chronic Obstructive Pulmonary Disease (COPD) is a complex heterogeneous condition with various clinical and pathologic features. In recent years, technical advances in quantitative CT imaging have generated considerable interest because they can provide a more precise and objective assessment of COPD. Emphysema and small-airway disease, the two major components of COPD, and other comorbidities, including pulmonary vessel alterations, atherosclerosis, cachexia, and osteoporosis, can all be assessed by means of quantitative imaging parameters. Increasing numbers of studies provide promising reports indicating that such parameters are associated with clinical measures of disease severity, respiratory symptoms, COPD exacerbations, and mortality. Despite such optimistic results, there are still many obstacles to using this quantitative technology in everyday practice to manage COPD patients. In this article, we review the current technical status of quantitative CT assessment, emphasizing its clinical implications and limitations. We also discuss present challenges and the potential future role of quantitative CT imaging in assessing COPD.

show abstract

CT Scan Findings of Emphysema Predict Mortality in COPD

Cited by 243 publications

References 33 publications

Six-Minute Walk Distance Predictors, Including CT Scan Measures, in the COPDGene Cohort

Six-Minute Walk Distance Predictors, Including CT Scan Measures, in the COPDGene Cohort

The Impact of Emphysema on Chronic Obstructive Pulmonary Diseases

Quantitative CT Imaging in Chronic Obstructive Pulmonary Disease: Review of Current Status and Future Challenges

Contact Info

Product

Resources

About