RT Journal Article
SR Electronic
T1 The prevalence and physiological impacts of centrilobular and paraseptal emphysema on computed tomography in smokers with preserved ratio impaired spirometry
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00063-2022
DO 10.1183/23120541.00063-2022
VO 8
IS 2
A1 Yusuke Shiraishi
A1 Takafumi Shimada
A1 Naoya Tanabe
A1 Kunihiko Terada
A1 Ryo Sakamoto
A1 Tomoki Maetani
A1 Hiroshi Shima
A1 Fumi Mochizuki
A1 Tsuyoshi Oguma
A1 Kaoruko Shimizu
A1 Susumu Sato
A1 Shigeo Muro
A1 Nobuyuki Hizawa
A1 Motonari Fukui
A1 Hiroaki Iijima
A1 Izuru Masuda
A1 Toyohiro Hirai
YR 2022
UL http://openres.ersjournals.com/content/8/2/00063-2022.abstract
AB 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 multicentre 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 ≥40 years who underwent computed tomography (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 (TLCCT).In 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 43.7% versus 1.2%, p<0.01; CLE 46% versus 4.7%, p<0.01) and lower than that in smokers with airflow limitation (PSE 43.7% versus 71.0%, p<0.01; CLE 46% 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.Centrilobular and paraseptal emphysema are observed in 43–46% of smokers with preserved ratio impaired spirometry. Centrilobular emphysema, but not paraseptal emphysema, is closely associated with air-trapping in these smokers. https://bit.ly/3Ky6LDy