TY - JOUR T1 - The prevalence and physiological impacts of centrilobular and paraseptal emphysema on CT in smokers with Preserved Ratio Impaired Spirometry JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00063-2022 SP - 00063-2022 AU - Yusuke Shiraishi AU - Takafumi Shimada AU - Naoya Tanabe AU - Kunihiko Terada AU - Ryo Sakamoto AU - Tomoki Maetani AU - Hiroshi Shima AU - Fumi Mochizuki AU - Tsuyoshi Oguma AU - Kaoruko Shimizu AU - Susumu Sato AU - Shigeo Muro AU - Nobuyuki Hizawa AU - Motonari Fukui AU - Hiroaki Iijima AU - Izuru Masuda AU - Toyohiro Hirai Y1 - 2022/01/01 UR - http://openres.ersjournals.com/content/early/2022/04/29/23120541.00063-2022.abstract N2 - Centrilobular emphysema (CLE) and paraseptal emphysema (PSE) are observed in smokers with Preserved Ratio Impaired Spirometry (PRISm, defined as the ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC)≥0.7 and FEV1<80%), but their prevalence and physiological impacts remain unestablished. This multicenter study aimed to investigate its prevalence and to test whether emphysema subtypes are differently associated with physiological impairments in smokers with PRISm.Both never and ever smokers aged at ≥40 years who underwent CT for lung cancer screening and spirometry were retrospectively and consecutively enrolled at three hospitals and a clinic. Emphysema subtypes were visually classified according to the Fleischner system. Air-trapping was assessed as the ratio of FVC to total lung capacity on CT (FVC/TLCCT).Of 1046 never-smokers and 772 smokers with >10 pack-years, the prevalence of PRISm was 8.2% and 11.3%, respectively. The prevalence of PSE and CLE in smokers with PRISm was comparable to that in smokers with normal spirometry (PSE 43.7% versus 36.2%, p=1.00, CLE 46.0% versus 31.8%, p=0.21), but higher than that in never-smokers with PRISm (PSE, versus 1.2%, p<0.01, CLE, versus 4.7%, p<0.01) and lower than that in smokers with airflow limitation (PSE, versus 71.0%, p<0.01, CLE, versus 79.3%, p<0.01). The presence of CLE but not PSE was independently associated with reduced FVC/TLCCT in smokers with PRISm.Both PSE and CLE were common, but only CLE was associated with air-trapping in smokers with PRISm, suggesting different physiological roles of these emphysema subtypes.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflicts of interest: N.T, S.S, T.O. and T.H. were supported by a grant from FUJIFILM Co., Ltd. ER -