Clinical significance of radiologic characterizations in COPD

Meilan K. Han, Brian Bartholmai, Lyrica X. Liu, Susan Murray, Jeffrey L. Curtis, Frank C. Sciurba, Ella A. Kazerooni, Bruce Thompson, Margaret Frederick, Daner Li, Marvin Schwarz, Andrew Limper, Christine Freeman, Rodney J. Landreneau, Robert Wise, Fernando J. Martinez

Research output: Contribution to journalArticle

69 Scopus citations

Abstract

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 FEV1 predicted, emphysema percent, and VBT. VBT scores > 2 (scale 048) were associated with increased exacerbation frequency (p 0.009) in the preceding year adjusting for age, gender, emphysema percent, smoking history and FEV1 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.

Original languageEnglish (US)
Pages (from-to)459-467
Number of pages9
JournalCOPD: Journal of Chronic Obstructive Pulmonary Disease
Volume6
Issue number6
DOIs
StatePublished - Dec 1 2009

Keywords

  • BODE
  • COPD
  • Exacerbation
  • HRCT
  • HRQL

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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    Han, M. K., Bartholmai, B., Liu, L. X., Murray, S., Curtis, J. L., Sciurba, F. C., Kazerooni, E. A., Thompson, B., Frederick, M., Li, D., Schwarz, M., Limper, A., Freeman, C., Landreneau, R. J., Wise, R., & Martinez, F. J. (2009). Clinical significance of radiologic characterizations in COPD. COPD: Journal of Chronic Obstructive Pulmonary Disease, 6(6), 459-467. https://doi.org/10.3109/15412550903341513