%0 Journal Article
%T Emphysema distribution and annual changes in pulmonary function in male patients with chronic obstructive pulmonary disease
%A Naoya Tanabe
%A Shigeo Muro
%A Shiro Tanaka
%A Susumu Sato
%A Tsuyoshi Oguma
%A Hirofumi Kiyokawa
%A Tamaki Takahashi
%A Daisuke Kinose
%A Yuma Hoshino
%A Takeshi Kubo
%A Emiko Ogawa
%A Toyohiro Hirai
%A Michiaki Mishima
%J Respiratory Research
%D 2012
%I BioMed Central
%R 10.1186/1465-9921-13-31
%X We followed up 131 male patients with COPD for a median of 3.7£¿years. We measured wall area percent (WA%) in right apical segmental bronchus, total lung volume, percent low attenuation volume (LAV%), and the standard deviation (SD) of LAV% values from CT images of 10 isovolumetric partitions (SD-LAV) as an index of cranial-caudal emphysema heterogeneity. Annual changes in FEV1 were then determined using a random coefficient model and relative contribution of baseline clinical parameters, pulmonary function, and CT indexes including LAV%, SD-LAV, and WA% to annual changes in FEV1 were examined.The mean (SD) annual change in FEV1 was £¿44.4 (10.8) mL. Multivariate random coefficient model showed that higher baseline FEV1, higher LAV%, current smoking, and lower SD-LAV independently contributed to an excessive decline in FEV1, whereas ratio of residual volume to total lung capacity, ratio of diffusing capacity to alveolar ventilation, and WA% did not, after adjusting for age, height, weight, and ratio of CT-measured total lung volume to physiologically-measured total lung capacity.A more homogeneous distribution of emphysema contributed to an accelerated decline in FEV1 independently of baseline pulmonary function, whole-lung emphysema severity, and smoking status. In addition to whole-lung analysis of emphysema, CT assessment of the cranial-caudal distribution of emphysema might be useful for predicting rapid, progressive disease and for developing a targeted strategy with which to prevent disease progression.
%K Chronic obstructive pulmonary diseases
%K COPD
%K CT
%K Emphysema
%K Lung function
%K Heterogeneity
%U http://respiratory-research.com/content/13/1/31/abstract