Title: Associations between emphysema-like lung on CT and incident airflow limitation: a general population-based cohort study.

Authors: Oelsner, Elizabeth C; Smith, Benjamin M; Hoffman, Eric A; Folsom, Aaron R; Kawut, Steven M; Kaufman, Joel D; Manichaikul, Ani; Lederer, David J; Schwartz, Joseph E; Watson, Karol E; Enright, Paul L; Austin, John H M; Lima, Joao A C; Shea, Steven J; Barr, Robert G

Published In Thorax, (2018 05)

Abstract: Emphysema on CT is associated with accelerated lung function decline in heavy smokers and patients with COPD; however, in the general population, it is not known whether greater emphysema-like lung on CT is associated with incident COPD. We used data from 2045 adult participants without initial prebronchodilator airflow limitation, classified by FEV1/FVC<0.70, in the Multi-Ethnic Study of Atherosclerosis. Emphysema-like lung on baseline cardiac CT, defined as per cent low attenuation areas<-950HU>upper limit of normal, was associated with increased odds of incident airflow limitation at 5-year follow-up on both prebronchodilator (adjusted OR 2.62, 95% CI 1.47 to 4.67) and postbronchodilator (adjusted OR 4.38, 95% CI 1.63 to 11.74) spirometry, independent of smoking history. These results support investigation into whether emphysema-like lung could be informative for COPD risk stratification.

PubMed ID: 29074811

MeSH Terms: Bronchodilator Agents/therapeutic use; Cohort Studies; Female; Forced Expiratory Volume; Humans; Male; Middle Aged; Pulmonary Disease, Chronic Obstructive/epidemiology*; Pulmonary Emphysema/diagnostic imaging*; Pulmonary Emphysema/physiopathology*; Risk Assessment; Tomography, X-Ray Computed; United States/epidemiology; Vital Capacity