Association of Dysanapsis with FEV1 Decline in Early COPD: The BEACON Cohort

<bold>Background:</bold> We seek to assess airway dysanapsis, a known risk factor for COPD development, in a young cohort of individuals with a smoking history. <bold>Methods:</bold> Participants of the British Early COPD Network (BEACON) cohort (smokers, aged 30-45 yrs, with >10 pack-yrs tobacco history and normal (>80% predicted) FEV1) (<ext-link>NCT03480347</ext-link>) were investigated with Quantitative CT. Dysanapsis (airway-to-lung ratio) was assessed as the geometric mean of airway lumen diameters in centimeters measured at 19 standard anatomic locations divided by the cube-root of total lung volume (cubic centimeters). Lower values indicate smaller airway tree caliber relative to lung size and higher values indicate larger airway tree caliber relative to lung size. <bold>Results:</bold> The annualised FEV1 decline rate in the BEACON cohort was -36.4ml/yr (95% CI (−44.4 to -28.4; P <0.001) during this study (median 34 months). Participants within quartile 1 containing the smallest airway-to-lung ratios had a faster FEV1 decline (−57 mL/y [14 mL/y]) than those in the upper quartile of highest airway-to-lung ratios (−27 mL/y [8 mL/y]). The lowest quartile also contained subjects with more emphysema (0.087% vs 0.040%, p<0.001), lower baseline FEV1 and spirometric ratios despite well balanced demographics (table). <bold>Conclusion:</bold> Contrary to prarticipants with established COPD and smaller airway-to-lung ratio had faster decline in lung function with poorer spirometry and structural measurements.

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Published
2024-09-14
DOI
https://doi.org/10.1183/13993003.congress-2024.pa3038
Primary Topic
Pneumocystis jirovecii pneumonia detection and treatment
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article
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article

Association of Dysanapsis with FEV1 Decline in Early COPD: The BEACON Cohort

Robert Andrew Stockley, Dave Singh, Eric A. Hoffman, Kristoffer Ostridge et al.
Pneumocystis jirovecii pneumonia detection and treatment
article

Association of Dysanapsis with FEV1 Decline in Early COPD: The BEACON Cohort

Robert Andrew Stockley, Dave Singh, Eric A. Hoffman, Kristoffer Ostridge, Luana Alves-Moreira, Hana Müllerová, Lorcan McGarvey, Enrica Bucchioni, Elizabeth Sapey, Chloë I. Bloom, Andrew I. Ritchie, Gavin Donaldson, James P. Allinson, Charlotte E. Bolton, Thomas S. Wilkinson, Christopher Compton, Kay Por Yip, Karen Mezzi, Sarah E. Gerard, Benjamin C. Smith, Jørgen Vestbo, Gourab Choudhury, Olaf Jöns, Junfeng Guo, Paul Jones, Jadwiga A. Wedzicha, Peter Calverley
article en

Abstract

<bold>Background:</bold> We seek to assess airway dysanapsis, a known risk factor for COPD development, in a young cohort of individuals with a smoking history. <bold>Methods:</bold> Participants of the British Early COPD Network (BEACON) cohort (smokers, aged 30-45 yrs, with >10 pack-yrs tobacco history and normal (>80% predicted) FEV1) (<ext-link>NCT03480347</ext-link>) were investigated with Quantitative CT. Dysanapsis (airway-to-lung ratio) was assessed as the geometric mean of airway lumen diameters in centimeters measured at 19 standard anatomic locations divided by the cube-root of total lung volume (cubic centimeters). Lower values indicate smaller airway tree caliber relative to lung size and higher values indicate larger airway tree caliber relative to lung size. <bold>Results:</bold> The annualised FEV1 decline rate in the BEACON cohort was -36.4ml/yr (95% CI (−44.4 to -28.4; P <0.001) during this study (median 34 months). Participants within quartile 1 containing the smallest airway-to-lung ratios had a faster FEV1 decline (−57 mL/y [14 mL/y]) than those in the upper quartile of highest airway-to-lung ratios (−27 mL/y [8 mL/y]). The lowest quartile also contained subjects with more emphysema (0.087% vs 0.040%, p<0.001), lower baseline FEV1 and spirometric ratios despite well balanced demographics (table). <bold>Conclusion:</bold> Contrary to prarticipants with established COPD and smaller airway-to-lung ratio had faster decline in lung function with poorer spirometry and structural measurements.

AstraZeneca (United Kingdom) (GB), Queen's University Belfast (GB), University of Iowa (US), Novartis (Switzerland) (CH), University of Liverpool (GB), University of Manchester (GB), AstraZeneca (Netherlands) (NL), AstraZeneca (Singapore) (SG), Chiesi Foundation (IT), AstraZeneca (Poland) (PL), Nottingham Biomedical Research Centre (GB), Boehringer Ingelheim (China) (CN), Smiths Detection (Canada) (CA), Southampton City Council (GB), Iowa City Public Library (US), The Queen's Medical Research Institute (GB), Institute of Infection and Immunity (CA), Swecare (SE), University of Southampton (GB), Imperial College London (GB), McGill University (CA), University of Birmingham (GB)
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