Standardized airway wall thickness Pi10 from routine CT scans of COPD patients as imaging biomarker for disease severity, lung function decline, and mortality

被引：11

作者：

Kahnert, Kathrin ^{[1
]}

Joerres, Rudolf A. ^{[2
]}

Kauczor, Hans-Ulrich ^{[3
,4
]}

Alter, Peter ^{[5
]}

Trudzinski, Franziska C. ^{[6
]}

Herth, Felix ^{[6
]}

Jobst, Bertram ^{[3
,4
]}

Weinheimer, Oliver ^{[3
,4
]}

Nauck, Sebastian ^{[3
,4
]}

Mertsch, Pontus ^{[1
]}

Kauffmann-Guerrero, Diego ^{[1
]}

Behr, Juergen ^{[1
]}

Bals, Robert ^{[7
,8
]}

Watz, Henrik ^{[9
]}

Rabe, Klaus F. ^{[10
,11
]}

Welte, Tobias ^{[12
]}

Vogelmeier, Claus F. ^{[5
]}

Biederer, Juergen ^{[3
,4
,11
,13
]}

机构：

[1] Ludwig Maximilians Univ Munchen, Univ Hosp, German Ctr Lung Res DZL, Dept Med 5,Comprehens Pneumol Ctr, Ziemssenstr 5, D-80336 Munich, Germany

[2] Ludwig Maximilians Univ Munchen, Inst & Outpatient Clin Occupat Social & Environm, Comprehens Pneumol Ctr Munich CPC M, German Ctr Lung Res DZL, Munich, Germany

[3] Univ Hosp Heidelberg, Dept Diagnost & Intervent Radiol, Heidelberg, Germany

[4] German Ctr Lung Res, Translat Lung Res Ctr Heidelberg TLRC, Heidelberg, Germany

[5] Philipps Univ Marburg, German Ctr Lung Res IDZL, Dept Med Pulm & Crit Care Med, Univ Med Ctr Giessen & Marburg, Marburg, Germany

[6] Translat Lung Res Ctr Heidelberg TLRC, Thoraxklin Heidelberg gGmbH, German Ctr Lung Res OZU, Heidelberg, Germany

[7] Saarland Univ Hosp, Dept Internal Med Pulmonol Allergol Resp Intens C, Homburg, Germany

[8] Helmholtz Ctr Infect Res HZI, Helmholtz Inst Pharmaceut Res Saarland HIPS, Saarland Univ Campus, Saarbrucken, Germany

[9] German Ctr Lung Res KULL, Airway Res Ctr North ARCN, Pulm Res Inst LungenClin Grosshansdorf, Grosshansdorf, Germany

[10] Lung Clin Grosshansdorf Airway Res Ctr ARCN, Grosshansdorf, Germany

[11] Christian Albrechts Univ Kiel, Fac Med, Kiel, Germany

[12] Hannover Med Sch, Dept Pneumol, Hannover, Germany

[13] Univ Latvia, Fac Med, Raina Bulvaris 19, LV-1586 Riga, Latvia

来源：

THERAPEUTIC ADVANCES IN RESPIRATORY DISEASE | 2023年 / 17卷

关键词：

COPD; CT based phenotyping; mortality; Pi10; triple therapy; OBSTRUCTIVE PULMONARY-DISEASE; ALL-CAUSE MORTALITY; COMPUTED-TOMOGRAPHY; EXACERBATIONS; EMPHYSEMA; SMOKERS; POPULATION; DIMENSIONS; SEX; AGE;

D O I：

10.1177/17534666221148663

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Background:: Chest computed tomography (CT) is increasingly used for phenotyping and monitoring of patients with COPD. The aim of this work was to evaluate the association of Pi10 as a measure of standardized airway wall thickness on CT with exacerbations, mortality, and response to triple therapy. Methods: Patients of GOLD grades 1-4 of the COSYCONET cohort with prospective CT scans were included. Pi10 was automatically computed and analyzed for its relationship to COPD severity, comorbidities, lung function, respiratory therapy, and mortality over a 6-year period, using univariate and multivariate comparisons. Results: We included n=433 patients (61%male). Pi10 was dependent on both GOLD grades 1-4 (p=0.009) and GOLD groups A-D (p=0.008); it was particularly elevated in group D, and ROC analysis yielded a cut-off of 0.26cm. Higher Pi10 was associated to lower FEV1 % predicted and higher RV/TLC, moreover the annual changes of lung function parameters (p<0.05), as well as to an airway-dominated phenotype and a history of myocardial infarction (p=0.001). These associations were confirmed in multivariate analyses. Pi10 was lower in patients receiving triple therapy, in particular in patients of GOLD groups C and D. Pi10 was also a significant predictor for mortality (p=0.006), even after including multiple other predictors. Conclusion: In summary, Pi10 was found to be predictive for the course of the disease in COPD, in particular mortality. The fact that Pi10 was lower in patients with severe COPD receiving triple therapy might hint toward additional effects of this functional therapy on airway remodeling.

引用

页数：14