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01.04.2020 | WORLD TRADE CENTER RELATED LUNG DISEASE

Quantitative CT Evidence of Airway Inflammation in WTC Workers and Volunteers with Low FVC Spirometric Pattern

verfasst von: Jonathan Weber, Anthony P. Reeves, John T. Doucette, Yunho Jeon, Akshay Sood, Raúl San José Estépar, Juan C. Celedón, Rafael E. de la Hoz

Erschienen in: Lung | Ausgabe 3/2020

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Abstract

Background

The most common abnormal spirometric pattern reported in WTC worker and volunteer cohorts has consistently been that of a nonobstructive reduced forced vital capacity (low FVC). Low FVC is associated with obesity, which is highly prevalent in these cohorts. We used quantitative CT (QCT) to investigate proximal and distal airway inflammation and emphysema in participants with stable low FVC pattern.

Methods

We selected study participants with at least two available longitudinal surveillance spirometries, and a chest CT with QCT measurements of proximal airway inflammation (wall area percent, WAP), end-expiratory air trapping, suggestive of distal airway obstruction (expiratory to inspiratory mean lung attenuation ratio, MLA_EI), and emphysema (percentage of lung volume with attenuation below − 950 HU, LAV%). The comparison groups in multinomial logistic regression models were participants with consistently normal spirometries, and participants with stable fixed obstruction (COPD).

Results

Compared to normal spirometry participants, and after adjusting for age, sex, race/ethnicity, BMI, smoking, and early arrival at the WTC disaster site, low FVC participants had higher WAP (OR_adj 1.24, 95% CI 1.06, 1.45, per 5% unit), suggestive of proximal airway inflammation, but did not differ in MLA_EI, or LAV%. COPD participants did not differ in WAP with the low FVC ones and were more likely to have higher MLA_EI or LAV% than the other two subgroups.

Discussion

WTC workers with spirometric low FVC have higher QCT-measured WAP compared to those with normal spirometries, but did not differ in distal airway and emphysema measurements, independently of obesity, smoking, and other covariates.

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Titel: Quantitative CT Evidence of Airway Inflammation in WTC Workers and Volunteers with Low FVC Spirometric Pattern
verfasst von: Jonathan Weber
Anthony P. Reeves
John T. Doucette
Yunho Jeon
Akshay Sood
Raúl San José Estépar
Juan C. Celedón
Rafael E. de la Hoz
Publikationsdatum: 01.04.2020
Verlag: Springer US
Erschienen in: Lung / Ausgabe 3/2020
Print ISSN: 0341-2040
Elektronische ISSN: 1432-1750
DOI: https://doi.org/10.1007/s00408-020-00350-5

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Quantitative CT Evidence of Airway Inflammation in WTC Workers and Volunteers with Low FVC Spirometric Pattern

Abstract

Background

Methods

Results

Discussion

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Abstract

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Discussion

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