Science and Research

Emphysema- and airway-dominant COPD phenotypes defined by standardised quantitative computed tomography

EvA (Emphysema versus Airway disease) is a multicentre project to study mechanisms and identify biomarkers of emphysema and airway disease in chronic obstructive pulmonary disease (COPD). The objective of this study was to delineate objectively imaging-based emphysema-dominant and airway disease-dominant phenotypes using quantitative computed tomography (QCT) indices, standardised with a novel phantom-based approach.441 subjects with COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages 1-3) were assessed in terms of clinical and physiological measurements, laboratory testing and standardised QCT indices of emphysema and airway wall geometry.QCT indices were influenced by scanner non-conformity, but standardisation significantly reduced variability (p<0.001) and led to more robust phenotypes. Four imaging-derived phenotypes were identified, reflecting "emphysema-dominant", "airway disease-dominant", "mixed" disease and "mild" disease. The emphysema-dominant group had significantly higher lung volumes, lower gas transfer coefficient, lower oxygen (PO2 ) and carbon dioxide (PCO2 ) tensions, higher haemoglobin and higher blood leukocyte numbers than the airway disease-dominant group.The utility of QCT for phenotyping in the setting of an international multicentre study is improved by standardisation. QCT indices of emphysema and airway disease can delineate within a population of patients with COPD, phenotypic groups that have typical clinical features known to be associated with emphysema-dominant and airway-dominant disease.
  • Subramanian, D. R.
  • Gupta, S.
  • Burggraf, D.
  • Vom Silberberg, S. J.
  • Heimbeck, I.
  • Heiss-Neumann, M. S.
  • Haeussinger, K.
  • Newby, C.
  • Hargadon, B.
  • Raj, V.
  • Singh, D.
  • Kolsum, U.
  • Hofer, T. P.
  • Al-Shair, K.
  • Luetzen, N.
  • Prasse, A.
  • Muller-Quernheim, J.
  • Benea, G.
  • Leprotti, S.
  • Boschetto, P.
  • Gorecka, D.
  • Nowinski, A.
  • Oniszh, K.
  • Castell, W. Z.
  • Hagen, M.
  • Barta, I.
  • Dome, B.
  • Strausz, J.
  • Greulich, T.
  • Vogelmeier, C.
  • Koczulla, A. R.
  • Gut, I.
  • Hohlfeld, J.
  • Welte, T.
  • Lavae-Mokhtari, M.
  • Ziegler-Heitbrock, L.
  • Brightling, C.
  • Parr, D. G.

Keywords

  • Adult
  • Aged
  • Europe
  • Female
  • Forced Expiratory Volume
  • Humans
  • Male
  • Middle Aged
  • *Phenotype
  • Pulmonary Disease, Chronic Obstructive/*diagnostic imaging/*physiopathology
  • Pulmonary Emphysema/*diagnostic imaging
  • Respiratory System/physiopathology
  • Spirometry
  • Tomography, X-Ray Computed/*standards
Publication details
DOI: 10.1183/13993003.01878-2015
Journal: The European respiratory journal
Pages: 92-103 
Number: 1
Work Type: Original
Location: BREATH, CPC-M, UGMLC
Disease Area: COPD
Partner / Member: LMU, MHH, UMR
Access-Number: 27230444
See publication on PubMed

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