Radiographic lung volumes predict progression to COPD in smokers with preserved spirometry in SPIROMICS

SPIROMICS investigators

Research output: Contribution to journalArticle

Abstract

The characteristics that predict progression to overt chronic obstructive pulmonary disease (COPD) in smokers without spirometric airflow obstruction are not clearly defined.We conducted a post hoc analysis of 849 current and former smokers (≥20 pack-years) with preserved spirometry from the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) cohort who had baseline computed tomography (CT) scans of lungs and serial spirometry. We examined whether CT-derived lung volumes representing air trapping could predict adverse respiratory outcomes and more rapid decline in spirometry to overt COPD using mixed-effect linear modelling.Among these subjects with normal forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio, CT-measured residual volume (RVCT) to total lung capacity (TLCCT) ratio varied widely, from 21% to 59%. Over 2.5±0.7 years of follow-up, subjects with higher RVCT/TLCCT had a greater differential rate of decline in FEV1/FVC; those in the upper RVCT/TLCCT tertile had a 0.66% (95% CI 0.06%-1.27%) faster rate of decline per year compared with those in the lower tertile (p=0.015) regardless of demographics, baseline spirometry, respiratory symptoms score, smoking status (former versus current) or smoking burden (pack-years). Accordingly, subjects with higher RVCT/TLCCT were more likely to develop spirometric COPD (OR 5.7 (95% CI 2.4-13.2) in upper versus lower RVCT/TLCCT tertile; p<0.001). Other CT indices of air trapping showed similar patterns of association with lung function decline; however, when all CT indices of air trapping, emphysema, and airway disease were included in the same model, only RVCT/TLCCT retained its significance.Increased air trapping based on radiographic lung volumes predicts accelerated spirometry decline and progression to COPD in smokers without obstruction.

Original languageEnglish (US)
JournalThe European respiratory journal
Volume54
Issue number4
DOIs
StatePublished - Oct 1 2019

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Total Lung Capacity
Spirometry
Chronic Obstructive Pulmonary Disease
Outcome Assessment (Health Care)
Lung
Tomography
Air
Vital Capacity
Forced Expiratory Volume
Smoking
Residual Volume
Emphysema
Cohort Studies
Demography

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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Radiographic lung volumes predict progression to COPD in smokers with preserved spirometry in SPIROMICS. / SPIROMICS investigators.

In: The European respiratory journal, Vol. 54, No. 4, 01.10.2019.

Research output: Contribution to journalArticle

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title = "Radiographic lung volumes predict progression to COPD in smokers with preserved spirometry in SPIROMICS",
abstract = "The characteristics that predict progression to overt chronic obstructive pulmonary disease (COPD) in smokers without spirometric airflow obstruction are not clearly defined.We conducted a post hoc analysis of 849 current and former smokers (≥20 pack-years) with preserved spirometry from the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) cohort who had baseline computed tomography (CT) scans of lungs and serial spirometry. We examined whether CT-derived lung volumes representing air trapping could predict adverse respiratory outcomes and more rapid decline in spirometry to overt COPD using mixed-effect linear modelling.Among these subjects with normal forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio, CT-measured residual volume (RVCT) to total lung capacity (TLCCT) ratio varied widely, from 21{\%} to 59{\%}. Over 2.5±0.7 years of follow-up, subjects with higher RVCT/TLCCT had a greater differential rate of decline in FEV1/FVC; those in the upper RVCT/TLCCT tertile had a 0.66{\%} (95{\%} CI 0.06{\%}-1.27{\%}) faster rate of decline per year compared with those in the lower tertile (p=0.015) regardless of demographics, baseline spirometry, respiratory symptoms score, smoking status (former versus current) or smoking burden (pack-years). Accordingly, subjects with higher RVCT/TLCCT were more likely to develop spirometric COPD (OR 5.7 (95{\%} CI 2.4-13.2) in upper versus lower RVCT/TLCCT tertile; p<0.001). Other CT indices of air trapping showed similar patterns of association with lung function decline; however, when all CT indices of air trapping, emphysema, and airway disease were included in the same model, only RVCT/TLCCT retained its significance.Increased air trapping based on radiographic lung volumes predicts accelerated spirometry decline and progression to COPD in smokers without obstruction.",
author = "{SPIROMICS investigators} and Mehrdad Arjomandi and Siyang Zeng and Igor Barjaktarevic and Barr, {R. Graham} and Bleecker, {Eugene R.} and Bowler, {Russell P.} and Buhr, {Russell G.} and Criner, {Gerard J.} and Comellas, {Alejandro P.} and Cooper, {Christopher B.} and Couper, {David J.} and Curtis, {Jeffrey L.} and Dransfield, {Mark T.} and Han, {Mei Lan K.} and Hansel, {Nadia N.} and Hoffman, {Eric A.} and Kaner, {Robert J.} and Kanner, {Richard E.} and Krishnan, {Jerry A.} and Robert Paine and Peters, {Stephen P.} and Rennard, {Stephen I.} and Woodruff, {Prescott G.}",
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T1 - Radiographic lung volumes predict progression to COPD in smokers with preserved spirometry in SPIROMICS

AU - SPIROMICS investigators

AU - Arjomandi, Mehrdad

AU - Zeng, Siyang

AU - Barjaktarevic, Igor

AU - Barr, R. Graham

AU - Bleecker, Eugene R.

AU - Bowler, Russell P.

AU - Buhr, Russell G.

AU - Criner, Gerard J.

AU - Comellas, Alejandro P.

AU - Cooper, Christopher B.

AU - Couper, David J.

AU - Curtis, Jeffrey L.

AU - Dransfield, Mark T.

AU - Han, Mei Lan K.

AU - Hansel, Nadia N.

AU - Hoffman, Eric A.

AU - Kaner, Robert J.

AU - Kanner, Richard E.

AU - Krishnan, Jerry A.

AU - Paine, Robert

AU - Peters, Stephen P.

AU - Rennard, Stephen I.

AU - Woodruff, Prescott G.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - The characteristics that predict progression to overt chronic obstructive pulmonary disease (COPD) in smokers without spirometric airflow obstruction are not clearly defined.We conducted a post hoc analysis of 849 current and former smokers (≥20 pack-years) with preserved spirometry from the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) cohort who had baseline computed tomography (CT) scans of lungs and serial spirometry. We examined whether CT-derived lung volumes representing air trapping could predict adverse respiratory outcomes and more rapid decline in spirometry to overt COPD using mixed-effect linear modelling.Among these subjects with normal forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio, CT-measured residual volume (RVCT) to total lung capacity (TLCCT) ratio varied widely, from 21% to 59%. Over 2.5±0.7 years of follow-up, subjects with higher RVCT/TLCCT had a greater differential rate of decline in FEV1/FVC; those in the upper RVCT/TLCCT tertile had a 0.66% (95% CI 0.06%-1.27%) faster rate of decline per year compared with those in the lower tertile (p=0.015) regardless of demographics, baseline spirometry, respiratory symptoms score, smoking status (former versus current) or smoking burden (pack-years). Accordingly, subjects with higher RVCT/TLCCT were more likely to develop spirometric COPD (OR 5.7 (95% CI 2.4-13.2) in upper versus lower RVCT/TLCCT tertile; p<0.001). Other CT indices of air trapping showed similar patterns of association with lung function decline; however, when all CT indices of air trapping, emphysema, and airway disease were included in the same model, only RVCT/TLCCT retained its significance.Increased air trapping based on radiographic lung volumes predicts accelerated spirometry decline and progression to COPD in smokers without obstruction.

AB - The characteristics that predict progression to overt chronic obstructive pulmonary disease (COPD) in smokers without spirometric airflow obstruction are not clearly defined.We conducted a post hoc analysis of 849 current and former smokers (≥20 pack-years) with preserved spirometry from the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) cohort who had baseline computed tomography (CT) scans of lungs and serial spirometry. We examined whether CT-derived lung volumes representing air trapping could predict adverse respiratory outcomes and more rapid decline in spirometry to overt COPD using mixed-effect linear modelling.Among these subjects with normal forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio, CT-measured residual volume (RVCT) to total lung capacity (TLCCT) ratio varied widely, from 21% to 59%. Over 2.5±0.7 years of follow-up, subjects with higher RVCT/TLCCT had a greater differential rate of decline in FEV1/FVC; those in the upper RVCT/TLCCT tertile had a 0.66% (95% CI 0.06%-1.27%) faster rate of decline per year compared with those in the lower tertile (p=0.015) regardless of demographics, baseline spirometry, respiratory symptoms score, smoking status (former versus current) or smoking burden (pack-years). Accordingly, subjects with higher RVCT/TLCCT were more likely to develop spirometric COPD (OR 5.7 (95% CI 2.4-13.2) in upper versus lower RVCT/TLCCT tertile; p<0.001). Other CT indices of air trapping showed similar patterns of association with lung function decline; however, when all CT indices of air trapping, emphysema, and airway disease were included in the same model, only RVCT/TLCCT retained its significance.Increased air trapping based on radiographic lung volumes predicts accelerated spirometry decline and progression to COPD in smokers without obstruction.

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