Chronic obstructive pulmonary disease exacerbations in the COPDGene study: Associated radiologic phenotypes

Mei Lan K. Han, Ella A. Kazerooni, David A. Lynch, Lyrica X. Liu, Susan Murray, Jeffrey L. Curtis, Gerard J. Criner, Victor Kim, Russell P. Bowler, Nicola A. Hanania, Antonio R. Anzueto, Barry J. Make, John E. Hokanson, James D. Crapo, Edwin K. Silverman, Fernando J. Martinez, George R. Washko

Research output: Contribution to journalArticlepeer-review

265 Scopus citations

Abstract

Purpose: To test the hypothesis - given the increasing emphasis on quantitative computed tomographic (CT) phenotypes of chronic obstructive pulmonary disease (COPD) - that a relationship exists between COPD exacerbation frequency and quantitative CT measures of emphysema and airway disease. Materials and Methods: This research protocol was approved by the institutional review board of each participating institution, and all participants provided written informed consent. One thousand two subjects who were enrolled in the COPDGene Study and met the GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria for COPD with quantitative CT analysis were included. Total lung emphysema percentage was measured by using the attenuation mask technique with a -950-HU threshold. An automated program measured the mean wall thickness and mean wall area percentage in six segmental bronchi. The frequency of COPD exacerbation in the prior year was determined by using a questionnaire. Statistical analysis was performed to examine the relationship of exacerbation frequency with lung function and quantitative CT measurements. Results: In a multivariate analysis adjusted for lung function, bronchial wall thickness and total lung emphysema percentage were associated with COPD exacerbation frequency. Each 1-mm increase in bronchial wall thickness was associated with a 1.84-fold increase in annual exacerbation rate (P = .004). For patients with 35% or greater total emphysema, each 5% increase in emphysema was associated with a 1.18-fold increase in this rate (P = .047). Conclusion: Greater lung emphysema and airway wall thickness were associated with COPD exacerbations, independent of the severity of airflow obstruction. Quantitative CT can help identify subgroups of patients with COPD who experience exacerbations for targeted research and therapy development for individual phenotypes.

Original languageEnglish (US)
Pages (from-to)274-282
Number of pages9
JournalRadiology
Volume261
Issue number1
DOIs
StatePublished - Oct 2011

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Fingerprint Dive into the research topics of 'Chronic obstructive pulmonary disease exacerbations in the COPDGene study: Associated radiologic phenotypes'. Together they form a unique fingerprint.

Cite this