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

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

289 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

Bibliographical note

Funding Information:
Supported by Award R01 HL089897, R01 HL089856, R01 HL122438, and R44 HL118837 from the NHLBI. The COPDGene project is also supported by the COPD Foundation through contributions made to an Industry Advisory Board composed of AstraZeneca, Boehringer Ingelheim, Novartis, Pfizer, Siemens, Sunovion, and GlaxoSmithKline.

Keywords

FEV
Lung function
Parametric response mapping

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1164/rccm.201511-2219OC

http://europepmc.org/articles/pmc5003216

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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

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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 = "Funding Information: Supported by Award R01 HL089897, R01 HL089856, R01 HL122438, and R44 HL118837 from the NHLBI. The COPDGene project is also supported by the COPD Foundation through contributions made to an Industry Advisory Board composed of AstraZeneca, Boehringer Ingelheim, Novartis, Pfizer, Siemens, Sunovion, and GlaxoSmithKline.",

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

language = "English (US)",

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pages = "178--184",

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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.

N1 - Funding Information: Supported by Award R01 HL089897, R01 HL089856, R01 HL122438, and R44 HL118837 from the NHLBI. The COPDGene project is also supported by the COPD Foundation through contributions made to an Industry Advisory Board composed of AstraZeneca, Boehringer Ingelheim, Novartis, Pfizer, Siemens, Sunovion, and GlaxoSmithKline.

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

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

Abstract

Bibliographical note

Keywords

UN SDGs

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