Source: International Congress 2016 – Important factors, besides smoking, that relate to lung function and decline in lung function
Disease area: Airway diseases

Abstract

Background: Airway wall thickening and lumen narrowing have been associated with COPD and asthma, but the prognostic significance of large airway structure is unclear.Aim: To test if airway measures on CT were associated longitudinally with physiologic, anatomic, and clinical outcomes in the general population.Methods: MESA recruited participants ages 45-84 years without cardiovascular disease in 2000-02. Airway wall thickness (AWT), lumen diameter, 10mm luminal perimeter (Pi10), and wall area percent (WA%) were measured in two dimensions on cardiac CTs at baseline. Spirometry was performed in 2004-06 and 2010-12. Percent emphysema was defined on cardiac (2000-07) and full-lung (2010-12) CT. Respiratory mortality was classified by death certificate. Random-intercept mixed and proportional-hazards models were adjusted for age, sex, race/ethnicity, site, height, weight, scanner, smoking, and pack-years.Results: Repeated measures of lung function and percent emphysema were available for 3561 and 4108 participants; 6324 had 15-year mortality follow-up. Greater AWT and Pi10 were associated with more rapid FEV1 decline (P<.05). Smaller lumen diameter and greater WA% and Pi10 were associated with progression in percent emphysema (P<.001). Smaller lumen diameter and greater WA% were associated with 37% and 66% higher respiratory mortality per SD unit (P<.001). Associations were independent of emphysema and persisted without attenuation in non-asthmatics and never-smokers.Conclusions: Airway wall thickening predicted lung function decline and smaller lumen diameter predicted emphysema progression and respiratory mortality over 15 years, including in never-smokers.


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Elizabeth Oelsner (New York, United States of America), Elizabeth Oelsner, Eric Hoffman, Benjamin Smith, Erin Michos, David Jacobs, Ravi Kalhan, Daniel Rabinowitz, R. Graham Barr. Prognostic significance of large airway measures on computed tomography (CT) in the general population: The MESA-lung study. Eur Respir J 2016; 48: Suppl. 60, 4999

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