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Clinical significance of radiologic characterizations in COPD.

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  • معلومة اضافية
    • المصدر:
      Publisher: Informa Healthcare Country of Publication: England NLM ID: 101211769 Publication Model: Print Cited Medium: Internet ISSN: 1541-2563 (Electronic) Linking ISSN: 15412563 NLM ISO Abbreviation: COPD Subsets: MEDLINE
    • بيانات النشر:
      Publication: London : Informa Healthcare
      Original Publication: Monticello, NY : Marcel Dekker, c2004-
    • الموضوع:
      Pulmonary Disease, Chronic Obstructive/*diagnostic imaging ; Pulmonary Disease, Chronic Obstructive/*physiopathology ; Pulmonary Emphysema/*diagnostic imaging ; Pulmonary Emphysema/*physiopathology ; Tomography, X-Ray Computed/*methods; Age Factors ; Aged ; Body Mass Index ; Cohort Studies ; Dyspnea/diagnosis ; Dyspnea/epidemiology ; Exercise Tolerance ; Female ; Humans ; Linear Models ; Male ; Middle Aged ; Multivariate Analysis ; Poisson Distribution ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive/genetics ; Pulmonary Emphysema/genetics ; Pulmonary Gas Exchange ; Respiratory Function Tests ; Risk Assessment ; Severity of Illness Index ; Sex Factors
    • نبذة مختصرة :
      COPD is a heterogeneous disorder with clinical assessment becoming increasingly multidimensional. We hypothesized HRCT phenotype would strongly influence clinical outcomes including health status, exacerbation frequency, and BODE. COPD subjects were characterized via the SF-12, SGRQ, MMRC, physiologic testing, and standardized volumetric chest HRCT. Visual semi-quantitative estimation of bronchial wall thickness (VBT) and automated quantification of emphysema percent and bronchial wall thickness were generated. Multivariate modeling compared emphysema severity and airway abnormality with clinical outcome measures. Poisson models were used to analyze exacerbation frequency. SGRQ and SF-12 physical component scores were influenced by FEV(1)% predicted, emphysema percent, and VBT. VBT scores > 2 (scale 0-48) were associated with increased exacerbation frequency (p = 0.009) in the preceding year adjusting for age, gender, emphysema percent, smoking history and FEV(1)% predicted, although this effect was attenuated by age. Emphysema percent correlated with total BODE score in unadjusted (r = 0.73; p < 0.0001) and adjusted (p < 0.0001) analyses and with BODE individual components. HRCT provides unique COPD phenotyping information. Radiographic quantification of emphysema and bronchial thickness are independently associated with SGRQ and physical component score of the SF-12. Bronchial thickness but not emphysema is associated with exacerbation frequency, whereas emphysema is a stronger predictor of BODE and its systemic components MMRC, 6MWT, and BMI. Future research should clarify whether CT parameters complement BODE score in influencing survival.
    • Grant Information:
      N01 HR46164 United States HR NHLBI NIH HHS; P50 HL084948 United States HL NHLBI NIH HHS; R01 HL082480 United States HL NHLBI NIH HHS; K24 HL04212 United States HL NHLBI NIH HHS; KL2 RR024987 United States RR NCRR NIH HHS; K24 HL004212 United States HL NHLBI NIH HHS; N01 HR46162 United States HR NHLBI NIH HHS; N01 HR46158 United States HR NHLBI NIH HHS; N01 HR46161 United States HR NHLBI NIH HHS; N01HR46163 United States HR NHLBI NIH HHS; N01 HR46160 United States HR NHLBI NIH HHS
    • الموضوع:
      Date Created: 20091127 Date Completed: 20100224 Latest Revision: 20211020
    • الموضوع:
      20221213
    • الرقم المعرف:
      10.3109/15412550903341513
    • الرقم المعرف:
      19938970