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Cross-Sectional Analysis of the Utility of Pulmonary Function Tests in Predicting Emphysema in Ever-Smokers

Emphysema is largely an under-diagnosed medical condition that can exist in smokers in the absence of airway obstruction. We aimed to determine the sensitivity and specificity of pulmonary function tests (PFTs) in assessing emphysema using quantitative CT scans as the reference standard. We enrolled...

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Autores principales: Hesselbacher, Sean E., Ross, Robert, Schabath, Matthew B., Smith, E. O’Brian, Perusich, Sarah, Barrow, Nadia, Smithwick, Pamela, Mammen, Manoj J., Coxson, Harvey, Krowchuk, Natasha, Corry, David B., Kheradmand, Farrah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Molecular Diversity Preservation International (MDPI) 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108112/
https://www.ncbi.nlm.nih.gov/pubmed/21655122
http://dx.doi.org/10.3390/ijerph8051324
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author Hesselbacher, Sean E.
Ross, Robert
Schabath, Matthew B.
Smith, E. O’Brian
Perusich, Sarah
Barrow, Nadia
Smithwick, Pamela
Mammen, Manoj J.
Coxson, Harvey
Krowchuk, Natasha
Corry, David B.
Kheradmand, Farrah
author_facet Hesselbacher, Sean E.
Ross, Robert
Schabath, Matthew B.
Smith, E. O’Brian
Perusich, Sarah
Barrow, Nadia
Smithwick, Pamela
Mammen, Manoj J.
Coxson, Harvey
Krowchuk, Natasha
Corry, David B.
Kheradmand, Farrah
author_sort Hesselbacher, Sean E.
collection PubMed
description Emphysema is largely an under-diagnosed medical condition that can exist in smokers in the absence of airway obstruction. We aimed to determine the sensitivity and specificity of pulmonary function tests (PFTs) in assessing emphysema using quantitative CT scans as the reference standard. We enrolled 224 ever-smokers (current or former) over the age of 40. CT of thorax was used to quantify the low attenuation area (% emphysema), and to measure the standardized airway wall thickness. PFTs were used individually and in combination to predict their ability to discriminate radiographic emphysema. Significant emphysema (>7%) was detected in 122 (54%) subjects. Twenty six (21%) emphysema subjects had no evidence of airflow obstruction (FEV(1)/FVC ratio <70%), while all subjects with >23% emphysema showed airflow obstruction. The sensitivity and specificity of spirometry for detecting radiographic emphysema were 79% and 75%, respectively. Standardized airway wall thickness was increased in subjects with airflow obstruction, but did not correlate with emphysema severity. In this cohort of lifetime ever-smokers, PFTs alone were inadequate for diagnosing emphysema. Airway wall thickness quantified by CT morphometry was associated with airflow limitation, but not with emphysema indicating that the heterogeneous nature of lung disease in smokers may represent distinct phenotypes.
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spelling pubmed-31081122011-06-08 Cross-Sectional Analysis of the Utility of Pulmonary Function Tests in Predicting Emphysema in Ever-Smokers Hesselbacher, Sean E. Ross, Robert Schabath, Matthew B. Smith, E. O’Brian Perusich, Sarah Barrow, Nadia Smithwick, Pamela Mammen, Manoj J. Coxson, Harvey Krowchuk, Natasha Corry, David B. Kheradmand, Farrah Int J Environ Res Public Health Article Emphysema is largely an under-diagnosed medical condition that can exist in smokers in the absence of airway obstruction. We aimed to determine the sensitivity and specificity of pulmonary function tests (PFTs) in assessing emphysema using quantitative CT scans as the reference standard. We enrolled 224 ever-smokers (current or former) over the age of 40. CT of thorax was used to quantify the low attenuation area (% emphysema), and to measure the standardized airway wall thickness. PFTs were used individually and in combination to predict their ability to discriminate radiographic emphysema. Significant emphysema (>7%) was detected in 122 (54%) subjects. Twenty six (21%) emphysema subjects had no evidence of airflow obstruction (FEV(1)/FVC ratio <70%), while all subjects with >23% emphysema showed airflow obstruction. The sensitivity and specificity of spirometry for detecting radiographic emphysema were 79% and 75%, respectively. Standardized airway wall thickness was increased in subjects with airflow obstruction, but did not correlate with emphysema severity. In this cohort of lifetime ever-smokers, PFTs alone were inadequate for diagnosing emphysema. Airway wall thickness quantified by CT morphometry was associated with airflow limitation, but not with emphysema indicating that the heterogeneous nature of lung disease in smokers may represent distinct phenotypes. Molecular Diversity Preservation International (MDPI) 2011-05 2011-04-29 /pmc/articles/PMC3108112/ /pubmed/21655122 http://dx.doi.org/10.3390/ijerph8051324 Text en © 2011 by the authors; licensee MDPI, Basel, Switzerland. http://creativecommons.org/licenses/by/3.0 This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).
spellingShingle Article
Hesselbacher, Sean E.
Ross, Robert
Schabath, Matthew B.
Smith, E. O’Brian
Perusich, Sarah
Barrow, Nadia
Smithwick, Pamela
Mammen, Manoj J.
Coxson, Harvey
Krowchuk, Natasha
Corry, David B.
Kheradmand, Farrah
Cross-Sectional Analysis of the Utility of Pulmonary Function Tests in Predicting Emphysema in Ever-Smokers
title Cross-Sectional Analysis of the Utility of Pulmonary Function Tests in Predicting Emphysema in Ever-Smokers
title_full Cross-Sectional Analysis of the Utility of Pulmonary Function Tests in Predicting Emphysema in Ever-Smokers
title_fullStr Cross-Sectional Analysis of the Utility of Pulmonary Function Tests in Predicting Emphysema in Ever-Smokers
title_full_unstemmed Cross-Sectional Analysis of the Utility of Pulmonary Function Tests in Predicting Emphysema in Ever-Smokers
title_short Cross-Sectional Analysis of the Utility of Pulmonary Function Tests in Predicting Emphysema in Ever-Smokers
title_sort cross-sectional analysis of the utility of pulmonary function tests in predicting emphysema in ever-smokers
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108112/
https://www.ncbi.nlm.nih.gov/pubmed/21655122
http://dx.doi.org/10.3390/ijerph8051324
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