Targeting lung health in Coventry and Warwickshire: Relationship of breathlessness and location of emphysema with lung function.

<bold>Introduction:</bold> The national targeted lung health check (TLHC) programme is offering a lung cancer screening service to ever smokers aged 55-74 years. Locally, those identified as having moderate or severe emphysema on low dose CT scan are referred for full pulmonary function testing (PFT). The study aim was to assess whether MRC breathlessness score corroborated with lung function findings and whether there were any differences between those with centrilobular, panacinar or paraseptal emphysema. <bold>Methods:</bold> Consecutive patients who undertook lung function for TLHC between February 2022 and December 2023 were included. Demographics, PFT parameters, MRC score and radiological information were collected. PFT abnormality (using z-scores) was compared with MRC score and emphysema location using Chi-square, Spearman's rho coefficient and one-way Anova. <bold>Results:</bold> 168 patients were tested, 81% had moderate emphysema, 61% an MRC ≥2. Obstructive spirometry was seen in 37% of those with an MRC score ≥2, a reduced KCO in 35% and 18% had no PFT impairment. Z-scores were negatively correlated with MRC score for FEV1/FVC ratio (p=0.021) and TLCO (p=0.012). When grouped by z-score abnormality and MRC score ≥2 or <2, there was no association. Table 1 shows mean z-scores by emphysema location and significance between groups. <table-wrap><object-id>erj;64/suppl_68/PA1456/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><table><colgroup><col></col><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td>PFT parameter</td><td> Centrilobular </td><td>Paraseptal</td><td>Panacinar</td><td>p value</td></tr><tr><td>FEV1/FVC</td><td>-1.95</td><td>-1.59</td><td>-2.59</td><td>0.072</td></tr><tr><td>TLCO</td><td>-1.6</td><td>-1.1</td><td>-2.5</td><td>0.007</td></tr><tr><td>KCO</td><td>-1.9</td><td>-1.2</td><td>-2.6</td><td>0.002</td></tr><tr><td>TLC</td><td>1.1</td><td>0.6</td><td>1.5</td><td>0.025</td></tr></tbody></table></table-wrap> <bold>Conclusion:</bold> MRC breathlessness score shows correlations with obstruction and TLCO impairment but no correlation with abnormality. Those with paraseptal emphysema seem to be the least compromised.