Original investigationQuantitative CT Measurement of Cross-sectional Area of Small Pulmonary Vessel in COPD: Correlations with Emphysema and Airflow Limitation
Section snippets
Subjects
All subjects in our study were enrolled in the National Lung Screening Trial (NLST), a full description for which is available on the website (http://www.cancer.gov/nlst). Subjects were eligible to participate in the NLST if they were between the ages of 55 and 74 and had a history of at least 30 pack-years of cigarette smoking. All subjects in the trial gave written informed consent. This study and manuscript were reviewed and approved according to the NLST/Lung Screening Study Publications,
Characteristics of the Study Subjects
Characteristics of the patients including the results of PFT are presented in Table 1. According to the CT criteria in this study, 68 subjects were excluded. In addition, 44 subjects were excluded because of obvious abnormal parenchymal lesions other than emphysema (n = 2 for interstitial pneumonia, n = 1 for multiple nodules, n = 1 for atelectasis), pleural effusion (n = 1), and image noise (n = 39). Thus 191 patients (mean age, 62 ± 5 years; range, 56–74 years; 78 women, 61 ± 4 years and 113
Discussion
In the present study, we found that %CSA < 5 had a negative strong correlation with the extent of emphysema. Meanwhile, the correlations of %CSA < 5 with FEV1 % predicted and FEV1/FVC were significant but weak. These results support the concept that the vascular alteration closely correlates with the extent of emphysema rather than airway obstruction (13). Moreover, %CSA < 5 was significantly higher in subjects with bronchitis phenotype than in emphysema phenotype. In addition, this difference
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Dr. Washko was supported by k23 NIH Grant: 1K23HL089353-01A1 and the Parker B. Francis Foundation.
The NLST (NCT00047385) is registered at www.clinicaltrials.gov. Registered at www.clinicaltrials.gov; no.NCT00047385.