Age and small airway imaging abnormalities in subjects with and without airflow obstruction in spiromics

Carlos H. Martinez; Alejandro A. Diaz; Catherine Meldrum; Jeffrey L. Curtis; Christopher B. Cooper; Cheryl Pirozzi; Richard E. Kanner; Robert Paine; Prescott G. Woodruff; Eugene R. Bleecker; Nadia N. Hansel; R. Graham Barr; Nathaniel Marchetti; Gerard J. Criner; Ella A. Kazerooni; Eric A. Hoffman; Brian D. Ross; Craig J. Galban; Christine T. Cigolle; Fernando J. Martinez; Mei Lan K. Han

doi:10.1164/rccm.201604-0871OC

Age and small airway imaging abnormalities in subjects with and without airflow obstruction in spiromics

Carlos H. Martinez, Alejandro A. Diaz, Catherine Meldrum, Jeffrey L. Curtis, Christopher B. Cooper, Cheryl Pirozzi, Richard E. Kanner, Robert Paine, Prescott G. Woodruff, Eugene R. Bleecker, Nadia N. Hansel, R. Graham Barr, Nathaniel Marchetti, Gerard J. Criner, Ella A. Kazerooni, Eric A. Hoffman, Brian D. Ross, Craig J. Galban, Christine T. Cigolle, Fernando J. MartinezMei Lan K. Han

School of Medicine

Research output: Contribution to journal › Article › peer-review

40 Scopus citations

Abstract

Rationale: Aging is associated with reduced FEV1 to FVC ratio (FEV₁/FVC), hyperinflation, and alveolar enlargement, but little is known about how age affects small airways. Objectives: To determine if chest computed tomography (CT)-assessed functional small airway would increase with age, even among asymptomatic individuals. Methods: We used parametric response mapping analysis of paired inspiratory/expiratory CTs to identify functional small airway abnormality (PRM^FSA) and emphysema (PRM^EMPH) in the SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study) cohort. Using adjusted linear regression models, we analyzed associations between PRM^FSA and age in subjects with or without airflow obstruction. We subdivided participants with normal spirometry based on respiratory-related impairment (6-minute-walk distance <350 m, modified Medical Research Council ≥2, chronic bronchitis, St. George's Respiratory Questionnaire >25, respiratory events requiring treatment [antibiotics and/or steroids or hospitalization] in the year before enrollment). Measurements and Main Results: Among 580 never- and ever-smokers without obstruction or respiratory impairment, PRM^FSA increased 2.7% per decade, ranging from 3.6% (ages 40-50 yr) to 12.7% (ages 70-80 yr). PRM^EMPH increased nonsignificantly (0.1% [ages 40-50 yr] to 0.4% [ages 70-80 yr]; P = 0.34). Associations were similar among nonobstructed individuals with respiratory-related impairment. Increasing PRM^FSA in subjects without airflow obstruction was associated with increased FVC (P = 0.004) but unchanged FEV₁ (P = 0.94), yielding lower FEV₁/FVC ratios (P < 0.001). Although emphysema was also significantly associated with lower FEV₁/FVC (P = 0.04), its contribution relative to PRM^FSA in those without airflow obstruction was limited by its low burden. Conclusions: In never- and ever-smokers without airflow obstruction, aging is associated with increased FVC and CT-defined functional small airway abnormality regardless of respiratory symptoms.

Original language	English (US)
Pages (from-to)	464-472
Number of pages	9
Journal	American journal of respiratory and critical care medicine
Volume	195
Issue number	4
DOIs	https://doi.org/10.1164/rccm.201604-0871OC
State	Published - Feb 15 2017

Keywords

Aging
Geriatrics
Imaging analysis
Lung function
Spirometry

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine

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10.1164/rccm.201604-0871OC

Cite this

Martinez, C. H., Diaz, A. A., Meldrum, C., Curtis, J. L., Cooper, C. B., Pirozzi, C., Kanner, R. E., Paine, R., Woodruff, P. G., Bleecker, E. R., Hansel, N. N., Barr, R. G., Marchetti, N., Criner, G. J., Kazerooni, E. A., Hoffman, E. A., Ross, B. D., Galban, C. J., Cigolle, C. T., ... Han, M. L. K. (2017). Age and small airway imaging abnormalities in subjects with and without airflow obstruction in spiromics. American journal of respiratory and critical care medicine, 195(4), 464-472. https://doi.org/10.1164/rccm.201604-0871OC

Martinez, CH, Diaz, AA, Meldrum, C, Curtis, JL, Cooper, CB, Pirozzi, C, Kanner, RE, Paine, R, Woodruff, PG, Bleecker, ER, Hansel, NN, Barr, RG, Marchetti, N, Criner, GJ, Kazerooni, EA, Hoffman, EA, Ross, BD, Galban, CJ, Cigolle, CT, Martinez, FJ & Han, MLK 2017, 'Age and small airway imaging abnormalities in subjects with and without airflow obstruction in spiromics', American journal of respiratory and critical care medicine, vol. 195, no. 4, pp. 464-472. https://doi.org/10.1164/rccm.201604-0871OC

@article{8d1c22b1a3c64fe8bbe3291711356cf5,

title = "Age and small airway imaging abnormalities in subjects with and without airflow obstruction in spiromics",

abstract = "Rationale: Aging is associated with reduced FEV1 to FVC ratio (FEV1/FVC), hyperinflation, and alveolar enlargement, but little is known about how age affects small airways. Objectives: To determine if chest computed tomography (CT)-assessed functional small airway would increase with age, even among asymptomatic individuals. Methods: We used parametric response mapping analysis of paired inspiratory/expiratory CTs to identify functional small airway abnormality (PRMFSA) and emphysema (PRMEMPH) in the SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study) cohort. Using adjusted linear regression models, we analyzed associations between PRMFSA and age in subjects with or without airflow obstruction. We subdivided participants with normal spirometry based on respiratory-related impairment (6-minute-walk distance <350 m, modified Medical Research Council ≥2, chronic bronchitis, St. George's Respiratory Questionnaire >25, respiratory events requiring treatment [antibiotics and/or steroids or hospitalization] in the year before enrollment). Measurements and Main Results: Among 580 never- and ever-smokers without obstruction or respiratory impairment, PRMFSA increased 2.7% per decade, ranging from 3.6% (ages 40-50 yr) to 12.7% (ages 70-80 yr). PRMEMPH increased nonsignificantly (0.1% [ages 40-50 yr] to 0.4% [ages 70-80 yr]; P = 0.34). Associations were similar among nonobstructed individuals with respiratory-related impairment. Increasing PRMFSA in subjects without airflow obstruction was associated with increased FVC (P = 0.004) but unchanged FEV1 (P = 0.94), yielding lower FEV1/FVC ratios (P < 0.001). Although emphysema was also significantly associated with lower FEV1/FVC (P = 0.04), its contribution relative to PRMFSA in those without airflow obstruction was limited by its low burden. Conclusions: In never- and ever-smokers without airflow obstruction, aging is associated with increased FVC and CT-defined functional small airway abnormality regardless of respiratory symptoms.",

keywords = "Aging, Geriatrics, Imaging analysis, Lung function, Spirometry",

author = "Martinez, {Carlos H.} and Diaz, {Alejandro A.} and Catherine Meldrum and Curtis, {Jeffrey L.} and Cooper, {Christopher B.} and Cheryl Pirozzi and Kanner, {Richard E.} and Robert Paine and Woodruff, {Prescott G.} and Bleecker, {Eugene R.} and Hansel, {Nadia N.} and Barr, {R. Graham} and Nathaniel Marchetti and Criner, {Gerard J.} and Kazerooni, {Ella A.} and Hoffman, {Eric A.} and Ross, {Brian D.} and Galban, {Craig J.} and Cigolle, {Christine T.} and Martinez, {Fernando J.} and Han, {Mei Lan K.}",

year = "2017",

month = feb,

day = "15",

doi = "10.1164/rccm.201604-0871OC",

language = "English (US)",

volume = "195",

pages = "464--472",

journal = "American journal of respiratory and critical care medicine",

issn = "1073-449X",

publisher = "American Thoracic Society",

number = "4",

}

TY - JOUR

T1 - Age and small airway imaging abnormalities in subjects with and without airflow obstruction in spiromics

AU - Martinez, Carlos H.

AU - Diaz, Alejandro A.

AU - Meldrum, Catherine

AU - Curtis, Jeffrey L.

AU - Cooper, Christopher B.

AU - Pirozzi, Cheryl

AU - Kanner, Richard E.

AU - Paine, Robert

AU - Woodruff, Prescott G.

AU - Bleecker, Eugene R.

AU - Hansel, Nadia N.

AU - Barr, R. Graham

AU - Marchetti, Nathaniel

AU - Criner, Gerard J.

AU - Kazerooni, Ella A.

AU - Hoffman, Eric A.

AU - Ross, Brian D.

AU - Galban, Craig J.

AU - Cigolle, Christine T.

AU - Martinez, Fernando J.

AU - Han, Mei Lan K.

PY - 2017/2/15

Y1 - 2017/2/15

N2 - Rationale: Aging is associated with reduced FEV1 to FVC ratio (FEV1/FVC), hyperinflation, and alveolar enlargement, but little is known about how age affects small airways. Objectives: To determine if chest computed tomography (CT)-assessed functional small airway would increase with age, even among asymptomatic individuals. Methods: We used parametric response mapping analysis of paired inspiratory/expiratory CTs to identify functional small airway abnormality (PRMFSA) and emphysema (PRMEMPH) in the SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study) cohort. Using adjusted linear regression models, we analyzed associations between PRMFSA and age in subjects with or without airflow obstruction. We subdivided participants with normal spirometry based on respiratory-related impairment (6-minute-walk distance <350 m, modified Medical Research Council ≥2, chronic bronchitis, St. George's Respiratory Questionnaire >25, respiratory events requiring treatment [antibiotics and/or steroids or hospitalization] in the year before enrollment). Measurements and Main Results: Among 580 never- and ever-smokers without obstruction or respiratory impairment, PRMFSA increased 2.7% per decade, ranging from 3.6% (ages 40-50 yr) to 12.7% (ages 70-80 yr). PRMEMPH increased nonsignificantly (0.1% [ages 40-50 yr] to 0.4% [ages 70-80 yr]; P = 0.34). Associations were similar among nonobstructed individuals with respiratory-related impairment. Increasing PRMFSA in subjects without airflow obstruction was associated with increased FVC (P = 0.004) but unchanged FEV1 (P = 0.94), yielding lower FEV1/FVC ratios (P < 0.001). Although emphysema was also significantly associated with lower FEV1/FVC (P = 0.04), its contribution relative to PRMFSA in those without airflow obstruction was limited by its low burden. Conclusions: In never- and ever-smokers without airflow obstruction, aging is associated with increased FVC and CT-defined functional small airway abnormality regardless of respiratory symptoms.

AB - Rationale: Aging is associated with reduced FEV1 to FVC ratio (FEV1/FVC), hyperinflation, and alveolar enlargement, but little is known about how age affects small airways. Objectives: To determine if chest computed tomography (CT)-assessed functional small airway would increase with age, even among asymptomatic individuals. Methods: We used parametric response mapping analysis of paired inspiratory/expiratory CTs to identify functional small airway abnormality (PRMFSA) and emphysema (PRMEMPH) in the SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study) cohort. Using adjusted linear regression models, we analyzed associations between PRMFSA and age in subjects with or without airflow obstruction. We subdivided participants with normal spirometry based on respiratory-related impairment (6-minute-walk distance <350 m, modified Medical Research Council ≥2, chronic bronchitis, St. George's Respiratory Questionnaire >25, respiratory events requiring treatment [antibiotics and/or steroids or hospitalization] in the year before enrollment). Measurements and Main Results: Among 580 never- and ever-smokers without obstruction or respiratory impairment, PRMFSA increased 2.7% per decade, ranging from 3.6% (ages 40-50 yr) to 12.7% (ages 70-80 yr). PRMEMPH increased nonsignificantly (0.1% [ages 40-50 yr] to 0.4% [ages 70-80 yr]; P = 0.34). Associations were similar among nonobstructed individuals with respiratory-related impairment. Increasing PRMFSA in subjects without airflow obstruction was associated with increased FVC (P = 0.004) but unchanged FEV1 (P = 0.94), yielding lower FEV1/FVC ratios (P < 0.001). Although emphysema was also significantly associated with lower FEV1/FVC (P = 0.04), its contribution relative to PRMFSA in those without airflow obstruction was limited by its low burden. Conclusions: In never- and ever-smokers without airflow obstruction, aging is associated with increased FVC and CT-defined functional small airway abnormality regardless of respiratory symptoms.

KW - Aging

KW - Geriatrics

KW - Imaging analysis

KW - Lung function

KW - Spirometry

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JO - American journal of respiratory and critical care medicine

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IS - 4

ER -

Age and small airway imaging abnormalities in subjects with and without airflow obstruction in spiromics

Abstract

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ASJC Scopus subject areas

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