Quantitative computed tomography phenotypes, spirometric parameters, and episodes of exacerbation in heavy smokers: An analysis from South America.
OBJECTIVE:To evaluate the quantitative computed tomography (QCT) phenotypes, airflow limitations, and exacerbation-like episodes in heavy smokers in Southern Brazil. METHODS:We enrolled 172 smokers with a smoking history ≥30 pack-years who underwent pulmonary function tests (PFTs) and CT scan for lu...
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doaj-1c8a5940d0904c01875dd5b2883248f92020-11-25T01:26:49ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-011310e020527310.1371/journal.pone.0205273Quantitative computed tomography phenotypes, spirometric parameters, and episodes of exacerbation in heavy smokers: An analysis from South America.Marcelo Cardoso BarrosBruno HochheggerStephan AltmayerGuilherme WatteMatheus ZanonAna Paula SartoriDaniela Cavalet BlancoGabriel Sartori PaciniJose Miguel ChatkinOBJECTIVE:To evaluate the quantitative computed tomography (QCT) phenotypes, airflow limitations, and exacerbation-like episodes in heavy smokers in Southern Brazil. METHODS:We enrolled 172 smokers with a smoking history ≥30 pack-years who underwent pulmonary function tests (PFTs) and CT scan for lung cancer screening. Patients were classified regarding airflow limitation (FEV1/FVC <0.7 forced expiratory volume in 1 second/forced vital capacity) and the presence of emphysema on the QCT. The QCT were analyzed in specialized software and patients were classified in two disease-predominant phenotypes: emphysema-predominant (EP) and non-emphysema-predominant (NEP). EP was determined as ≥6% of percent low-attenuation areas (LAA%) with less than -950 Hounsfield units. NEP was defined as having a total LAA% of less than 6%. RESULTS:Most of our patients were classified in the EP phenotype. The EP group had significantly worse predicted FEV1 (60.6 ±22.9 vs. 89.7 ±15.9, p <0.001), higher rates of airflow limitation (85.7% vs. 15%; p <0.001), and had more exacerbation-like episodes (25.8% vs. 8.3%, p <0.001) compared to the NEP group. Smoking history, ethnicity, and BMI did not differ between the groups. The total LAA% was the QCT parameter with the strongest correlation to FEV1 (r = -0.669) and FEV1/FVC (r = -0.787). CONCLUSIONS:Heavy smokers with the EP phenotype on QCT were more likely to have airflow limitation, worse predicted FEV1, and a higher rate of exacerbation-like episodes than those with the NEP phenotype. Approximately 23% of patients with no airflow limitation on PFTs were classified in EP phenotype.http://europepmc.org/articles/PMC6181358?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Marcelo Cardoso Barros Bruno Hochhegger Stephan Altmayer Guilherme Watte Matheus Zanon Ana Paula Sartori Daniela Cavalet Blanco Gabriel Sartori Pacini Jose Miguel Chatkin |
spellingShingle |
Marcelo Cardoso Barros Bruno Hochhegger Stephan Altmayer Guilherme Watte Matheus Zanon Ana Paula Sartori Daniela Cavalet Blanco Gabriel Sartori Pacini Jose Miguel Chatkin Quantitative computed tomography phenotypes, spirometric parameters, and episodes of exacerbation in heavy smokers: An analysis from South America. PLoS ONE |
author_facet |
Marcelo Cardoso Barros Bruno Hochhegger Stephan Altmayer Guilherme Watte Matheus Zanon Ana Paula Sartori Daniela Cavalet Blanco Gabriel Sartori Pacini Jose Miguel Chatkin |
author_sort |
Marcelo Cardoso Barros |
title |
Quantitative computed tomography phenotypes, spirometric parameters, and episodes of exacerbation in heavy smokers: An analysis from South America. |
title_short |
Quantitative computed tomography phenotypes, spirometric parameters, and episodes of exacerbation in heavy smokers: An analysis from South America. |
title_full |
Quantitative computed tomography phenotypes, spirometric parameters, and episodes of exacerbation in heavy smokers: An analysis from South America. |
title_fullStr |
Quantitative computed tomography phenotypes, spirometric parameters, and episodes of exacerbation in heavy smokers: An analysis from South America. |
title_full_unstemmed |
Quantitative computed tomography phenotypes, spirometric parameters, and episodes of exacerbation in heavy smokers: An analysis from South America. |
title_sort |
quantitative computed tomography phenotypes, spirometric parameters, and episodes of exacerbation in heavy smokers: an analysis from south america. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2018-01-01 |
description |
OBJECTIVE:To evaluate the quantitative computed tomography (QCT) phenotypes, airflow limitations, and exacerbation-like episodes in heavy smokers in Southern Brazil. METHODS:We enrolled 172 smokers with a smoking history ≥30 pack-years who underwent pulmonary function tests (PFTs) and CT scan for lung cancer screening. Patients were classified regarding airflow limitation (FEV1/FVC <0.7 forced expiratory volume in 1 second/forced vital capacity) and the presence of emphysema on the QCT. The QCT were analyzed in specialized software and patients were classified in two disease-predominant phenotypes: emphysema-predominant (EP) and non-emphysema-predominant (NEP). EP was determined as ≥6% of percent low-attenuation areas (LAA%) with less than -950 Hounsfield units. NEP was defined as having a total LAA% of less than 6%. RESULTS:Most of our patients were classified in the EP phenotype. The EP group had significantly worse predicted FEV1 (60.6 ±22.9 vs. 89.7 ±15.9, p <0.001), higher rates of airflow limitation (85.7% vs. 15%; p <0.001), and had more exacerbation-like episodes (25.8% vs. 8.3%, p <0.001) compared to the NEP group. Smoking history, ethnicity, and BMI did not differ between the groups. The total LAA% was the QCT parameter with the strongest correlation to FEV1 (r = -0.669) and FEV1/FVC (r = -0.787). CONCLUSIONS:Heavy smokers with the EP phenotype on QCT were more likely to have airflow limitation, worse predicted FEV1, and a higher rate of exacerbation-like episodes than those with the NEP phenotype. Approximately 23% of patients with no airflow limitation on PFTs were classified in EP phenotype. |
url |
http://europepmc.org/articles/PMC6181358?pdf=render |
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