RT Journal Article
SR Electronic
T1 Computed tomographic emphysema distribution: relationship to clinical features in a cohort of smokers
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 536
OP 542
DO 10.1183/09031936.00111808
VO 33
IS 3
A1 G. Mair
A1 J. J. Miller
A1 D. McAllister
A1 J. Maclay
A1 M. Connell
A1 J. T. Murchison
A1 W. MacNee
YR 2009
UL http://erj.ersjournals.com/content/33/3/536.abstract
AB Computed tomography (CT) scanning allows precise assessment of both the extent and distribution of emphysema. There has been little work on the relationship between the distribution of emphysema and clinical features of the disease. The current study investigated the association between clinical features and distribution of emphysema. A total of 129 patients with smoking-related chronic obstructive pulmonary disease underwent CT assessment of the extent and distribution of their emphysema (core/rind and upper/lower zone predominance). Emphysema was found predominantly in the upper/core zone and this distribution was related to the extent of disease. Core predominance was associated with lower forced expiratory volume in one second (FEV1), FEV1/forced vital capacity ratio and body mass index (BMI); and with higher BODE (BMI, airflow obstruction, dyspnoea and exercise capacity) index and Medical Research Council dyspnoea score. Upper-zone predominance was associated with female sex and an increased total St George’s Respiratory Questionnaire score. Using multiple linear regression age, sex and whole lung emphysema severity were independently associated with core/rind distribution, while sex and whole lung emphysema severity were independently related to upper/lower distribution. Distribution of emphysema related best to clinical features when divided into core/rind predominance. However, the effects were not independent of the extent of emphysema. Increased age and female sex were related to disease distribution independent of emphysema severity. These findings may be related to differences in development of emphysema.