Association between functional small airway disease and FEV1 decline in chronic obstructive pulmonary disease

Surya P. Bhatt; Xavier Soler; Xin Wang; Susan Murray; Antonio R. Anzueto; Terri H. Beaty; Aladin M. Boriek; Richard Casaburi; Gerard J. Criner; Alejandro A. Diaz; Mark T. Dransfield; Douglas Curran-Everett; Craig J. Galban; Eric A. Hoffman; James C. Hogg; Ella A. Kazerooni; Victor Kim; Gregory L. Kinney; Amir Lagstein; David A. Lynch; Barry J. Make; Fernando J. Martinez; Joe W. Ramsdell; Rishindra Reddy; Brian D. Ross; Harry B. Rossiter; Robert M. Steiner; Matthew J. Strand; Edwin J.R. Van Beek; Emily S. Wan; George R. Washko; J. Michael Wells; Chris H. Wendt; Robert A. Wise; Edwin K. Silverman; James D. Crapo; Russell P. Bowler; Meilan K. Han

doi:10.1164/rccm.201511-2219OC

Association between functional small airway disease and FEV1 decline in chronic obstructive pulmonary disease

Surya P. Bhatt, Xavier Soler, Xin Wang, Susan Murray, Antonio R. Anzueto, Terri H. Beaty, Aladin M. Boriek, Richard Casaburi, Gerard J. Criner, Alejandro A. Diaz, Mark T. Dransfield, Douglas Curran-Everett, Craig J. Galban, Eric A. Hoffman, James C. Hogg, Ella A. Kazerooni, Victor Kim, Gregory L. Kinney, Amir Lagstein, David A. LynchBarry J. Make, Fernando J. Martinez, Joe W. Ramsdell, Rishindra Reddy, Brian D. Ross, Harry B. Rossiter, Robert M. Steiner, Matthew J. Strand, Edwin J.R. Van Beek, Emily S. Wan, George R. Washko, J. Michael Wells, Chris H. Wendt, Robert A. Wise, Edwin K. Silverman, James D. Crapo, Russell P. Bowler, Meilan K. Han

Division of Pulmonary Diseases

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

311 Scopus citations

Abstract

Rationale: The small conducting airways are the major site of airflow obstruction in chronic obstructive pulmonary disease and may precede emphysema development. Objectives: We hypothesized a novel computed tomography (CT) biomarker of small airway disease predicts FEV₁ decline. Methods: We analyzed 1,508 current and former smokers from COPDGene with linear regression to assess predictors of change in FEV₁ (ml/yr) over 5 years. Separate models for subjects without and with airflow obstruction were generated using baseline clinical and physiologic predictors in addition to two novel CT metrics created by parametric response mapping (PRM), a technique pairing inspiratory and expiratory CT images to define emphysema (PRMemph) and functional small airways disease (PRMfSAD), a measure of nonemphysematous air trapping. Measurements and Main Results: Mean (SD) rate of FEV₁ decline in ml/yr for GOLD (Global Initiative for Chronic Obstructive Lung Disease) 0-4 was as follows: 41.8 (47.7), 53.8 (57.1), 45.6 (61.1), 31.6 (43.6), and 5.1 (35.8), respectively (trend test for grades 1-4; P < 0.001). In multivariable linear regression, for participants without airflow obstruction, PRMfSAD but not PRMemph was associated with FEV₁ decline (P < 0.001). In GOLD 1-4 participants, both PRMfSAD and PRMemph were associated with FEV₁ decline (P < 0.001 and P = 0.001, respectively). Based on the model, the proportional contribution of the two CT metrics to FEV₁ decline, relative to each other, was 87% versus 13% and 68% versus 32% for PRMfSAD and PRMemph in GOLD 1/2 and 3/4, respectively. Conclusions: CT-assessed functional small airway disease and emphysema are associated with FEV₁ decline, but the association with functional small airway disease has greatest importance in mildto-moderate stage chronic obstructive pulmonary disease where the rate of FEV₁ decline is the greatest. Clinical trial registered with www.clinicaltrials.gov (NCT 00608764).

Original language	English (US)
Pages (from-to)	178-184
Number of pages	7
Journal	American Journal of Respiratory and Critical Care Medicine
Volume	194
Issue number	2
DOIs	https://doi.org/10.1164/rccm.201511-2219OC
State	Published - Jul 15 2016

Keywords

FEV
Lung function
Parametric response mapping

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine

Access to Document

10.1164/rccm.201511-2219OC

Cite this

Bhatt, S. P., Soler, X., Wang, X., Murray, S., Anzueto, A. R., Beaty, T. H., Boriek, A. M., Casaburi, R., Criner, G. J., Diaz, A. A., Dransfield, M. T., Curran-Everett, D., Galban, C. J., Hoffman, E. A., Hogg, J. C., Kazerooni, E. A., Kim, V., Kinney, G. L., Lagstein, A., ... Han, M. K. (2016). Association between functional small airway disease and FEV1 decline in chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine, 194(2), 178-184. https://doi.org/10.1164/rccm.201511-2219OC

Bhatt, SP, Soler, X, Wang, X, Murray, S, Anzueto, AR, Beaty, TH, Boriek, AM, Casaburi, R, Criner, GJ, Diaz, AA, Dransfield, MT, Curran-Everett, D, Galban, CJ, Hoffman, EA, Hogg, JC, Kazerooni, EA, Kim, V, Kinney, GL, Lagstein, A, Lynch, DA, Make, BJ, Martinez, FJ, Ramsdell, JW, Reddy, R, Ross, BD, Rossiter, HB, Steiner, RM, Strand, MJ, Van Beek, EJR, Wan, ES, Washko, GR, Michael Wells, J, Wendt, CH, Wise, RA, Silverman, EK, Crapo, JD, Bowler, RP & Han, MK 2016, 'Association between functional small airway disease and FEV1 decline in chronic obstructive pulmonary disease', American Journal of Respiratory and Critical Care Medicine, vol. 194, no. 2, pp. 178-184. https://doi.org/10.1164/rccm.201511-2219OC

@article{034a8c40b2cc43fca6856e2258639ab6,

title = "Association between functional small airway disease and FEV1 decline in chronic obstructive pulmonary disease",

abstract = "Rationale: The small conducting airways are the major site of airflow obstruction in chronic obstructive pulmonary disease and may precede emphysema development. Objectives: We hypothesized a novel computed tomography (CT) biomarker of small airway disease predicts FEV1 decline. Methods: We analyzed 1,508 current and former smokers from COPDGene with linear regression to assess predictors of change in FEV1 (ml/yr) over 5 years. Separate models for subjects without and with airflow obstruction were generated using baseline clinical and physiologic predictors in addition to two novel CT metrics created by parametric response mapping (PRM), a technique pairing inspiratory and expiratory CT images to define emphysema (PRMemph) and functional small airways disease (PRMfSAD), a measure of nonemphysematous air trapping. Measurements and Main Results: Mean (SD) rate of FEV1 decline in ml/yr for GOLD (Global Initiative for Chronic Obstructive Lung Disease) 0-4 was as follows: 41.8 (47.7), 53.8 (57.1), 45.6 (61.1), 31.6 (43.6), and 5.1 (35.8), respectively (trend test for grades 1-4; P < 0.001). In multivariable linear regression, for participants without airflow obstruction, PRMfSAD but not PRMemph was associated with FEV1 decline (P < 0.001). In GOLD 1-4 participants, both PRMfSAD and PRMemph were associated with FEV1 decline (P < 0.001 and P = 0.001, respectively). Based on the model, the proportional contribution of the two CT metrics to FEV1 decline, relative to each other, was 87% versus 13% and 68% versus 32% for PRMfSAD and PRMemph in GOLD 1/2 and 3/4, respectively. Conclusions: CT-assessed functional small airway disease and emphysema are associated with FEV1 decline, but the association with functional small airway disease has greatest importance in mildto-moderate stage chronic obstructive pulmonary disease where the rate of FEV1 decline is the greatest. Clinical trial registered with www.clinicaltrials.gov (NCT 00608764).",

keywords = "FEV, Lung function, Parametric response mapping",

author = "Bhatt, {Surya P.} and Xavier Soler and Xin Wang and Susan Murray and Anzueto, {Antonio R.} and Beaty, {Terri H.} and Boriek, {Aladin M.} and Richard Casaburi and Criner, {Gerard J.} and Diaz, {Alejandro A.} and Dransfield, {Mark T.} and Douglas Curran-Everett and Galban, {Craig J.} and Hoffman, {Eric A.} and Hogg, {James C.} and Kazerooni, {Ella A.} and Victor Kim and Kinney, {Gregory L.} and Amir Lagstein and Lynch, {David A.} and Make, {Barry J.} and Martinez, {Fernando J.} and Ramsdell, {Joe W.} and Rishindra Reddy and Ross, {Brian D.} and Rossiter, {Harry B.} and Steiner, {Robert M.} and Strand, {Matthew J.} and {Van Beek}, {Edwin J.R.} and Wan, {Emily S.} and Washko, {George R.} and {Michael Wells}, J. and Wendt, {Chris H.} and Wise, {Robert A.} and Silverman, {Edwin K.} and Crapo, {James D.} and Bowler, {Russell P.} and Han, {Meilan K.}",

note = "Publisher Copyright: {\textcopyright} 2016 by the American Thoracic Society.",

year = "2016",

month = jul,

day = "15",

doi = "10.1164/rccm.201511-2219OC",

language = "English (US)",

volume = "194",

pages = "178--184",

journal = "American Journal of Respiratory and Critical Care Medicine",

issn = "1073-449X",

publisher = "American Thoracic Society",

number = "2",

}

TY - JOUR

T1 - Association between functional small airway disease and FEV1 decline in chronic obstructive pulmonary disease

AU - Bhatt, Surya P.

AU - Soler, Xavier

AU - Wang, Xin

AU - Murray, Susan

AU - Anzueto, Antonio R.

AU - Beaty, Terri H.

AU - Boriek, Aladin M.

AU - Casaburi, Richard

AU - Criner, Gerard J.

AU - Diaz, Alejandro A.

AU - Dransfield, Mark T.

AU - Curran-Everett, Douglas

AU - Galban, Craig J.

AU - Hoffman, Eric A.

AU - Hogg, James C.

AU - Kazerooni, Ella A.

AU - Kim, Victor

AU - Kinney, Gregory L.

AU - Lagstein, Amir

AU - Lynch, David A.

AU - Make, Barry J.

AU - Martinez, Fernando J.

AU - Ramsdell, Joe W.

AU - Reddy, Rishindra

AU - Ross, Brian D.

AU - Rossiter, Harry B.

AU - Steiner, Robert M.

AU - Strand, Matthew J.

AU - Van Beek, Edwin J.R.

AU - Wan, Emily S.

AU - Washko, George R.

AU - Michael Wells, J.

AU - Wendt, Chris H.

AU - Wise, Robert A.

AU - Silverman, Edwin K.

AU - Crapo, James D.

AU - Bowler, Russell P.

AU - Han, Meilan K.

PY - 2016/7/15

Y1 - 2016/7/15

N2 - Rationale: The small conducting airways are the major site of airflow obstruction in chronic obstructive pulmonary disease and may precede emphysema development. Objectives: We hypothesized a novel computed tomography (CT) biomarker of small airway disease predicts FEV1 decline. Methods: We analyzed 1,508 current and former smokers from COPDGene with linear regression to assess predictors of change in FEV1 (ml/yr) over 5 years. Separate models for subjects without and with airflow obstruction were generated using baseline clinical and physiologic predictors in addition to two novel CT metrics created by parametric response mapping (PRM), a technique pairing inspiratory and expiratory CT images to define emphysema (PRMemph) and functional small airways disease (PRMfSAD), a measure of nonemphysematous air trapping. Measurements and Main Results: Mean (SD) rate of FEV1 decline in ml/yr for GOLD (Global Initiative for Chronic Obstructive Lung Disease) 0-4 was as follows: 41.8 (47.7), 53.8 (57.1), 45.6 (61.1), 31.6 (43.6), and 5.1 (35.8), respectively (trend test for grades 1-4; P < 0.001). In multivariable linear regression, for participants without airflow obstruction, PRMfSAD but not PRMemph was associated with FEV1 decline (P < 0.001). In GOLD 1-4 participants, both PRMfSAD and PRMemph were associated with FEV1 decline (P < 0.001 and P = 0.001, respectively). Based on the model, the proportional contribution of the two CT metrics to FEV1 decline, relative to each other, was 87% versus 13% and 68% versus 32% for PRMfSAD and PRMemph in GOLD 1/2 and 3/4, respectively. Conclusions: CT-assessed functional small airway disease and emphysema are associated with FEV1 decline, but the association with functional small airway disease has greatest importance in mildto-moderate stage chronic obstructive pulmonary disease where the rate of FEV1 decline is the greatest. Clinical trial registered with www.clinicaltrials.gov (NCT 00608764).

AB - Rationale: The small conducting airways are the major site of airflow obstruction in chronic obstructive pulmonary disease and may precede emphysema development. Objectives: We hypothesized a novel computed tomography (CT) biomarker of small airway disease predicts FEV1 decline. Methods: We analyzed 1,508 current and former smokers from COPDGene with linear regression to assess predictors of change in FEV1 (ml/yr) over 5 years. Separate models for subjects without and with airflow obstruction were generated using baseline clinical and physiologic predictors in addition to two novel CT metrics created by parametric response mapping (PRM), a technique pairing inspiratory and expiratory CT images to define emphysema (PRMemph) and functional small airways disease (PRMfSAD), a measure of nonemphysematous air trapping. Measurements and Main Results: Mean (SD) rate of FEV1 decline in ml/yr for GOLD (Global Initiative for Chronic Obstructive Lung Disease) 0-4 was as follows: 41.8 (47.7), 53.8 (57.1), 45.6 (61.1), 31.6 (43.6), and 5.1 (35.8), respectively (trend test for grades 1-4; P < 0.001). In multivariable linear regression, for participants without airflow obstruction, PRMfSAD but not PRMemph was associated with FEV1 decline (P < 0.001). In GOLD 1-4 participants, both PRMfSAD and PRMemph were associated with FEV1 decline (P < 0.001 and P = 0.001, respectively). Based on the model, the proportional contribution of the two CT metrics to FEV1 decline, relative to each other, was 87% versus 13% and 68% versus 32% for PRMfSAD and PRMemph in GOLD 1/2 and 3/4, respectively. Conclusions: CT-assessed functional small airway disease and emphysema are associated with FEV1 decline, but the association with functional small airway disease has greatest importance in mildto-moderate stage chronic obstructive pulmonary disease where the rate of FEV1 decline is the greatest. Clinical trial registered with www.clinicaltrials.gov (NCT 00608764).

KW - FEV

KW - Lung function

KW - Parametric response mapping

UR - http://www.scopus.com/inward/record.url?scp=84988957314&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84988957314&partnerID=8YFLogxK

U2 - 10.1164/rccm.201511-2219OC

DO - 10.1164/rccm.201511-2219OC

M3 - Article

C2 - 26808615

AN - SCOPUS:84988957314

SN - 1073-449X

VL - 194

SP - 178

EP - 184

JO - American Journal of Respiratory and Critical Care Medicine

JF - American Journal of Respiratory and Critical Care Medicine

IS - 2

ER -

Association between functional small airway disease and FEV1 decline in chronic obstructive pulmonary disease

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this