Sex differences in emphysema phenotype in smokers without airflow obstruction

Sverzellati, Nicola; Calabrò, Elisa; Randi, Giorgia; Vecchia, Carlo La; Marchianò, Alfonso; Kuhnigk, Jan-Martin; Zompatori, Maurizio; Spagnolo, Paolo; Pastorino, Ugo

doi:10.1183/09031936.00109808

Cited by 43 publications

(34 citation statements)

References 37 publications

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“…Our results may not be extrapolated directly to females because it is known that males have more CT-quantified emphysema [17] and that sex is independently associated with upper or lower lung-predominant emphysema patterns [28]. Future studies should also include females to examine the association of emphysema distribution and lung function decline.…”

Section: Discussionmentioning

confidence: 99%

“…Exposure settings were 30 mA?s at 120 peak kilovoltage (kVp) or 140 kVp, depending on the participant's weight (f80 and .80 kg, respectively). This lowdose CT protocol has previously been used to quantify emphysema in COPD patients and heavy smokers [6,[16][17][18]. The vast majority of subjects was scanned on the Brilliance 16P scanner and a very small fraction (,1%) on the Mx8000 IDT scanner, which was used a back-up scanner.…”

Section: Computed Tomographymentioning

confidence: 99%

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Computed tomography-quantified emphysema distribution is associated with lung function decline

et al. 2012

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Emphysema distribution is associated with chronic obstructive pulmonary disease. It is, however, unknown whether computed tomography (CT)-quantified emphysema distribution (upper/lower lobe) is associated with lung function decline in heavy (former) smokers.587 male participants underwent lung CT and pulmonary function testing at baseline and after a median (interquartile range) follow-up of 2.9 (2.8-3.0) yrs. The lungs were automatically segmented based on anatomically defined lung lobes. Severity of emphysema was automatically quantified per anatomical lung lobe and was expressed as the 15th percentile (Hounsfield unit point below which 15% of the low-attenuation voxels are distributed (Perc15)). The CT-quantified emphysema distribution was based on principal component analysis. Linear mixed models were used to assess the association of emphysema distribution with forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC), FEV1 and FVC decline.Mean¡SD age was 60.2¡5.4 yrs, mean baseline FEV1/FVC was 71.6¡9.0% and overall mean Perc15 was -908.5¡20.9 HU. Participants with upper lobe-predominant CT-quantified emphysema had a lower FEV1/FVC, FEV1 and FVC after follow-up compared with participants with lower lobe-predominant CT-quantified emphysema (p50.001), independent of the total extent of CTquantified emphysema.Heavy (former) smokers with upper lobe-predominant CT-quantified emphysema have a more rapid decrease in lung function than those with lower lobe-predominant CT-quantified emphysema.

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Section: Discussionmentioning

confidence: 99%

Section: Computed Tomographymentioning

confidence: 99%

Computed tomography-quantified emphysema distribution is associated with lung function decline

et al. 2012

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“…The remaining 444 (35.9%) subjects were randomly selected by the computer and mixed up with the other 256 for review. Such cases had been included in another study addressing a separate hypothesis [10].…”

Section: Methodsmentioning

confidence: 99%

Interstitial lung diseases in a lung cancer screening trial

Sverzellati¹,

Guerci²,

Randi³

et al. 2011

Eur Respir J

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We assessed the prevalence of interstitial lung disease (ILD) in a cohort of smokers included in a lung cancer screening trial.Two observers independently reviewed, for the presence of findings consistent with ILD, the computed tomography (CT) examinations of 692 heavy smokers recruited by the Multicentric Italian Lung Detection (MILD) trial. Four CT patterns were considered: usual interstitial pneumonia (UIP), other chronic interstitial pneumonia (OCIP), respiratory bronchiolitis (RB) and indeterminate. Subsequently, the evolution of ILD in those subjects who had undergone a repeat CT examination after 3 yrs was assessed.The UIP pattern and the OCIP pattern were identified in two (0.3%) out of 692 and 26 (3.8%) out of 692 patients, respectively; 109 (15.7%) out of 692 patients showed CT abnormalities consistent with RB, while an indeterminate CT pattern was reported in 21 out of 692 (3%) patients. Age, male sex and current smoking status were factors associated with the presence of OCIP and UIP (combined) pattern, although the relationship did not attain statistical significance. A progression of the disease was observed in three (25%) out of 12 subjects with OCIP who underwent repeat CT after 3 yrs.Thin-section CT features of ILD, probably representing smoking-related ILD, are not uncommon in a lung cancer screening population and should not be overlooked.

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“…Exposure settings were 30 mAs at 120 kVp or 140 kVp, depending on the participant's weight. This low-dose CT protocol has previously been used to quantify emphysema in COPD patients and heavy smokers [16,17]. All CT scans were automatically analysed by software developed in-house [18].…”

Section: Ct Scanningmentioning

confidence: 99%

Association of the transfer coefficient of the lung for carbon monoxide with emphysema progression in male smokers

Hoesein¹,

Zanen²,

Ginneken³

et al. 2011

Eur Respir J

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A decreased transfer coefficient of the lung for carbon monoxide (KCO) is associated with emphysema. We evaluated whether in heavy smokers, baseline KCO was associated with the progression of computed tomography (CT)-detected emphysema, and the progression of airflow limitation.Heavy smokers, mean¡SD 41.3¡18.7 pack-yrs, participating in a lung cancer screening trial underwent diffusion testing and CT scanning of the lungs. CT scanning was repeated after median (25th-75th percentile) 2.8 (2.7-3.0) yrs and emphysema was assessed by lung densitometry using the 15th percentile. The association between KCO at baseline with progression of emphysema and lung function decline was assessed by multiple linear regression, correcting for baseline CTquantified emphysema severity and forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC), age, height, body mass index, pack-yrs and smoking status (current or former smoker).522 participants aged 60.1¡5.4 yrs were included. Mean¡SD 15th percentile was -938¡19, absolute FEV1/FVC was 71.6¡9% and KCO was 1.23¡0.25, which is 81.8¡16.5% of predicted. By interpolation, a one SD (0.25) lower KCO value at baseline predicted a 1.6 HU lower 15th percentile and a 0.78% lower FEV1/FVC after follow-up (p,0.001).A lower baseline KCO value is independently associated with a more rapid progression of emphysema and airflow limitation in heavy smokers.

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Sex differences in emphysema phenotype in smokers without airflow obstruction

Cited by 43 publications

References 37 publications

Computed tomography-quantified emphysema distribution is associated with lung function decline

Computed tomography-quantified emphysema distribution is associated with lung function decline

Interstitial lung diseases in a lung cancer screening trial

Association of the transfer coefficient of the lung for carbon monoxide with emphysema progression in male smokers

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