Prognostic Significance of Large Airway Dimensions on Computed Tomography in the General Population. The Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study
Published in
Annals of the American Thoracic Society, June 2018
Large airway dimensions on computed tomography (CT) have been associated with lung function, symptoms, and exacerbations in COPD, and symptoms in smokers with preserved spirometry. Their prognostic significance in persons without lung disease remains undefined.
To examine associations between large airway dimensions on CT and respiratory outcomes in a population-based cohort of adults without prevalent lung disease.
The Multi-Ethnic Study of Atherosclerosis recruited participants ages 45-84 years without cardiovascular disease in 2000-02; we excluded participants with prevalent chronic lower respiratory disease (CLRD). Spirometry was measured in 2004-06 and 2010-12. CLRD hospitalizations and deaths were classified by validated criteria through 2014. Pi10 was calculated as average wall thickness for a hypothetical airway of 10mm lumen perimeter from measures of airway wall thickness (AWT) and lumen diameter. Models were adjusted for age, sex, principal components of ancestry, BMI, smoking, pack-years, scanner, percent emphysema, genetic risk score, and initial FEV1 percent-predicted.
Greater Pi10 was associated with 9% faster FEV1 decline (95% CI 2%-15%, P=0.012) and increased incident COPD (OR 2.22; 95% CI 1.43-3.45, P=.0004) per standard deviation among 1,830 participants. Over 78,147 person-years, higher Pi10 was associated with 57% higher risk of first CLRD hospitalization or mortality (P=.0496) per standard deviation. Of Pi10's component measures, both greater AWT and narrower lumen predicted incident COPD and CLRD clinical events.
In adults without CLRD, large airway dimensions on CT were prospectively associated with accelerated lung function decline and increased risks of COPD and CLRD hospitalization and mortality.
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