Quantitative CT Evidence of Airway Inflammation in WTC Workers and Volunteers with Low FVC Spirometric Pattern
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) t...
Saved in:
Published in | Lung Vol. 198; no. 3; pp. 555 - 563 |
---|---|
Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
New York
Springer US
01.06.2020
Springer Springer Nature B.V |
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | 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. |
---|---|
Bibliography: | Authors’ contributions RED, RSJ, and JCC designed and oversaw the study and guided the analytical strategies. JW and JTD performed all statistical analyses. APR and RSJ established the WTC Chest CT Imaging Archive, appraised chest CT scan study quality for QCT, and APR performed the QCT measurements. All authors contributed to writing, and reviewed and revised the draft and the final manuscript. |
ISSN: | 0341-2040 1432-1750 |
DOI: | 10.1007/s00408-020-00350-5 |