High-resolution computed tomography quantitation of emphysema is correlated with selected lung function values in stable COPD

Silvestro Ennio D'Anna, Roberto Asnaghi, Gaetano Caramori, Lorenzo Appendini, Manfredi Rizzo, Carmelo Cavallaro, Giorgio Marino, Francesco Cappello, Bruno Balbi, Antonino Di Stefano

Research output: Contribution to journalArticle

Abstract

Background: The literature shows conflicting results when high-resolution computed tomography (HRCT) scores of emphysema were correlated with different indices of airflow obstruction. Objectives: We correlated HRCT scores of emphysema with different indices of airflow obstruction. Methods: We performed HRCT of the chest in 59 patients, all smokers or ex-smokers, with stable chronic obstructive pulmonary disease of different severity [GOLD stages I-IV; mean age ± SD 67.8 ± 7.3 years; pack/years 51.0 ± 34.6; percent predicted forced expiratory volume in 1 s (FEV1% predicted) 52.3 ± 17.6; post-bronchodilator FEV1% predicted 56.5 ± 19.1; FEV1/forced vital capacity (FVC) ratio 50.8 ± 10.2; post-bronchodilator FEV1/FVC ratio 51.6 ± 11.0; percent diffusion lung capacity for carbon monoxide (DLCO%) 59.2 ± 21.1; DLCO/percent alveolar volume (VA%) 54.5 ± 18.2; percent residual volume 163.0 ± 35.6; percent total lung capacity (TLC%) 113.2 ± 15; residual volume/TLC 1.44 ± 0.2]. All patients were in stable phase. Results: The mean ± SD visual emphysema score in all patients was 25.6 ± 25.4%. There was a weak but significant correlation between the percentage of pulmonary emphysema and numbers of pack/years (R = +0.31, p = 0.024). The percentage of emphysema was inversely correlated with the FEV 1/FVC ratio before and after bronchodilator use (R = -0.44, p = 0.002, and R = -0.39, p = 0.005), DLCO% (R = -0.64, p = 0.0003) and DLCO/VA% (R = -0.68, p <0.0001). A weak positive correlation was also found with TLC% (R = +0.28, p = 0.048). When patients with documented emphysema were considered separately, the best significant correlation observed was between DLCO/VA% and HRCT scan score (p = 0.007). Conclusions: These data suggest that in patients with stable chronic obstructive pulmonary disease of varying severity, the presence of pulmonary emphysema is best represented by the impaired gas exchange capability of the respiratory system.

Original languageEnglish
Pages (from-to)383-390
Number of pages8
JournalRespiration
Volume83
Issue number5
DOIs
Publication statusPublished - May 2012

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Emphysema
Chronic Obstructive Pulmonary Disease
Tomography
Bronchodilator Agents
Vital Capacity
Lung
Total Lung Capacity
Pulmonary Emphysema
Residual Volume
Lung Volume Measurements
Forced Expiratory Volume
Carbon Monoxide
Respiratory System
Thorax
Gases

Keywords

  • Chronic obstructive pulmonary disease
  • Emphysema
  • High-resolution computed tomography
  • Lung structural alterations

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

High-resolution computed tomography quantitation of emphysema is correlated with selected lung function values in stable COPD. / D'Anna, Silvestro Ennio; Asnaghi, Roberto; Caramori, Gaetano; Appendini, Lorenzo; Rizzo, Manfredi; Cavallaro, Carmelo; Marino, Giorgio; Cappello, Francesco; Balbi, Bruno; Di Stefano, Antonino.

In: Respiration, Vol. 83, No. 5, 05.2012, p. 383-390.

Research output: Contribution to journalArticle

D'Anna, Silvestro Ennio ; Asnaghi, Roberto ; Caramori, Gaetano ; Appendini, Lorenzo ; Rizzo, Manfredi ; Cavallaro, Carmelo ; Marino, Giorgio ; Cappello, Francesco ; Balbi, Bruno ; Di Stefano, Antonino. / High-resolution computed tomography quantitation of emphysema is correlated with selected lung function values in stable COPD. In: Respiration. 2012 ; Vol. 83, No. 5. pp. 383-390.
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title = "High-resolution computed tomography quantitation of emphysema is correlated with selected lung function values in stable COPD",
abstract = "Background: The literature shows conflicting results when high-resolution computed tomography (HRCT) scores of emphysema were correlated with different indices of airflow obstruction. Objectives: We correlated HRCT scores of emphysema with different indices of airflow obstruction. Methods: We performed HRCT of the chest in 59 patients, all smokers or ex-smokers, with stable chronic obstructive pulmonary disease of different severity [GOLD stages I-IV; mean age ± SD 67.8 ± 7.3 years; pack/years 51.0 ± 34.6; percent predicted forced expiratory volume in 1 s (FEV1{\%} predicted) 52.3 ± 17.6; post-bronchodilator FEV1{\%} predicted 56.5 ± 19.1; FEV1/forced vital capacity (FVC) ratio 50.8 ± 10.2; post-bronchodilator FEV1/FVC ratio 51.6 ± 11.0; percent diffusion lung capacity for carbon monoxide (DLCO{\%}) 59.2 ± 21.1; DLCO/percent alveolar volume (VA{\%}) 54.5 ± 18.2; percent residual volume 163.0 ± 35.6; percent total lung capacity (TLC{\%}) 113.2 ± 15; residual volume/TLC 1.44 ± 0.2]. All patients were in stable phase. Results: The mean ± SD visual emphysema score in all patients was 25.6 ± 25.4{\%}. There was a weak but significant correlation between the percentage of pulmonary emphysema and numbers of pack/years (R = +0.31, p = 0.024). The percentage of emphysema was inversely correlated with the FEV 1/FVC ratio before and after bronchodilator use (R = -0.44, p = 0.002, and R = -0.39, p = 0.005), DLCO{\%} (R = -0.64, p = 0.0003) and DLCO/VA{\%} (R = -0.68, p <0.0001). A weak positive correlation was also found with TLC{\%} (R = +0.28, p = 0.048). When patients with documented emphysema were considered separately, the best significant correlation observed was between DLCO/VA{\%} and HRCT scan score (p = 0.007). Conclusions: These data suggest that in patients with stable chronic obstructive pulmonary disease of varying severity, the presence of pulmonary emphysema is best represented by the impaired gas exchange capability of the respiratory system.",
keywords = "Chronic obstructive pulmonary disease, Emphysema, High-resolution computed tomography, Lung structural alterations",
author = "D'Anna, {Silvestro Ennio} and Roberto Asnaghi and Gaetano Caramori and Lorenzo Appendini and Manfredi Rizzo and Carmelo Cavallaro and Giorgio Marino and Francesco Cappello and Bruno Balbi and {Di Stefano}, Antonino",
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T1 - High-resolution computed tomography quantitation of emphysema is correlated with selected lung function values in stable COPD

AU - D'Anna, Silvestro Ennio

AU - Asnaghi, Roberto

AU - Caramori, Gaetano

AU - Appendini, Lorenzo

AU - Rizzo, Manfredi

AU - Cavallaro, Carmelo

AU - Marino, Giorgio

AU - Cappello, Francesco

AU - Balbi, Bruno

AU - Di Stefano, Antonino

PY - 2012/5

Y1 - 2012/5

N2 - Background: The literature shows conflicting results when high-resolution computed tomography (HRCT) scores of emphysema were correlated with different indices of airflow obstruction. Objectives: We correlated HRCT scores of emphysema with different indices of airflow obstruction. Methods: We performed HRCT of the chest in 59 patients, all smokers or ex-smokers, with stable chronic obstructive pulmonary disease of different severity [GOLD stages I-IV; mean age ± SD 67.8 ± 7.3 years; pack/years 51.0 ± 34.6; percent predicted forced expiratory volume in 1 s (FEV1% predicted) 52.3 ± 17.6; post-bronchodilator FEV1% predicted 56.5 ± 19.1; FEV1/forced vital capacity (FVC) ratio 50.8 ± 10.2; post-bronchodilator FEV1/FVC ratio 51.6 ± 11.0; percent diffusion lung capacity for carbon monoxide (DLCO%) 59.2 ± 21.1; DLCO/percent alveolar volume (VA%) 54.5 ± 18.2; percent residual volume 163.0 ± 35.6; percent total lung capacity (TLC%) 113.2 ± 15; residual volume/TLC 1.44 ± 0.2]. All patients were in stable phase. Results: The mean ± SD visual emphysema score in all patients was 25.6 ± 25.4%. There was a weak but significant correlation between the percentage of pulmonary emphysema and numbers of pack/years (R = +0.31, p = 0.024). The percentage of emphysema was inversely correlated with the FEV 1/FVC ratio before and after bronchodilator use (R = -0.44, p = 0.002, and R = -0.39, p = 0.005), DLCO% (R = -0.64, p = 0.0003) and DLCO/VA% (R = -0.68, p <0.0001). A weak positive correlation was also found with TLC% (R = +0.28, p = 0.048). When patients with documented emphysema were considered separately, the best significant correlation observed was between DLCO/VA% and HRCT scan score (p = 0.007). Conclusions: These data suggest that in patients with stable chronic obstructive pulmonary disease of varying severity, the presence of pulmonary emphysema is best represented by the impaired gas exchange capability of the respiratory system.

AB - Background: The literature shows conflicting results when high-resolution computed tomography (HRCT) scores of emphysema were correlated with different indices of airflow obstruction. Objectives: We correlated HRCT scores of emphysema with different indices of airflow obstruction. Methods: We performed HRCT of the chest in 59 patients, all smokers or ex-smokers, with stable chronic obstructive pulmonary disease of different severity [GOLD stages I-IV; mean age ± SD 67.8 ± 7.3 years; pack/years 51.0 ± 34.6; percent predicted forced expiratory volume in 1 s (FEV1% predicted) 52.3 ± 17.6; post-bronchodilator FEV1% predicted 56.5 ± 19.1; FEV1/forced vital capacity (FVC) ratio 50.8 ± 10.2; post-bronchodilator FEV1/FVC ratio 51.6 ± 11.0; percent diffusion lung capacity for carbon monoxide (DLCO%) 59.2 ± 21.1; DLCO/percent alveolar volume (VA%) 54.5 ± 18.2; percent residual volume 163.0 ± 35.6; percent total lung capacity (TLC%) 113.2 ± 15; residual volume/TLC 1.44 ± 0.2]. All patients were in stable phase. Results: The mean ± SD visual emphysema score in all patients was 25.6 ± 25.4%. There was a weak but significant correlation between the percentage of pulmonary emphysema and numbers of pack/years (R = +0.31, p = 0.024). The percentage of emphysema was inversely correlated with the FEV 1/FVC ratio before and after bronchodilator use (R = -0.44, p = 0.002, and R = -0.39, p = 0.005), DLCO% (R = -0.64, p = 0.0003) and DLCO/VA% (R = -0.68, p <0.0001). A weak positive correlation was also found with TLC% (R = +0.28, p = 0.048). When patients with documented emphysema were considered separately, the best significant correlation observed was between DLCO/VA% and HRCT scan score (p = 0.007). Conclusions: These data suggest that in patients with stable chronic obstructive pulmonary disease of varying severity, the presence of pulmonary emphysema is best represented by the impaired gas exchange capability of the respiratory system.

KW - Chronic obstructive pulmonary disease

KW - Emphysema

KW - High-resolution computed tomography

KW - Lung structural alterations

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