Abstract
Rationale: Lung volumes identify the “susceptible smokers” who progress to develop spirometric COPD, which seems to be a heterogenous process with staggered onset of different pathologic mechanisms in early disease.
Objective: Determine the radiographic patterns of emphysema and airway disease among susceptible smokers.
Methods: We categorized smokers with preserved spirometry (GOLD-0) in the COPDGene cohort (N=2,159) based on tertiles (low, intermediate, and high) of baseline lung volumes (TLC, FRC, or FRC/TLC), and examined the differential patterns of change in spirometry and the associated prevalence of CT-measured emphysema (Insp-950; PRMEmphysema) and airway disease (EXP-856; PRMAir Trapping; Pi10).
Results: The pattern of spirometric change differed when participants were categorized by TLC versus FRC/TLC: those in high TLC tertile showed stable FEV1 but enlarging FVC while those in high FRC/TLC tertile showed decline in both FEV1 and FVC. Compared to those with high TLC, those with high FRC/TLC had lesser emphysema but greater air trapping, more respiratory symptoms, more decline in physical activity, higher likelihood of progressing to more severe spirometric disease, and a trend towards more severe exacerbations.
Discussion: Lung volumes identify distinct phenotypes in early disease among susceptible smokers and predict the rate of spirometric disease progression and the severity of symptoms in early COPD.
Footnotes
Cite this article as Eur Respir J 2022; 60: Suppl. 66, 4674.
This article was presented at the 2022 ERS International Congress, in session “-”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2022
