The prevalence and physiological impacts of centrilobular and paraseptal emphysema on computed tomography in smokers with preserved ratio impaired spirometry
Centrilobular emphysema (CLE) and paraseptal emphysema (PSE) are observed in smokers with preserved ratio impaired spirometry (PRISm, defined as the ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ≥0.7 and FEV1 <80%), but their prevalence and physiological impacts r...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2022-06-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/8/2/00063-2022.full |
| _version_ | 1797809462506946560 |
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| author | Yusuke Shiraishi Takafumi Shimada Naoya Tanabe Kunihiko Terada Ryo Sakamoto Tomoki Maetani Hiroshi Shima Fumi Mochizuki Tsuyoshi Oguma Kaoruko Shimizu Susumu Sato Shigeo Muro Nobuyuki Hizawa Motonari Fukui Hiroaki Iijima Izuru Masuda Toyohiro Hirai |
| author_facet | Yusuke Shiraishi Takafumi Shimada Naoya Tanabe Kunihiko Terada Ryo Sakamoto Tomoki Maetani Hiroshi Shima Fumi Mochizuki Tsuyoshi Oguma Kaoruko Shimizu Susumu Sato Shigeo Muro Nobuyuki Hizawa Motonari Fukui Hiroaki Iijima Izuru Masuda Toyohiro Hirai |
| author_sort | Yusuke Shiraishi |
| collection | DOAJ |
| description | Centrilobular emphysema (CLE) and paraseptal emphysema (PSE) are observed in smokers with preserved ratio impaired spirometry (PRISm, defined as the ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ≥0.7 and FEV1 <80%), but their prevalence and physiological impacts remain unestablished. This multicentre study aimed to investigate its prevalence and to test whether emphysema subtypes are differently associated with physiological impairments in smokers with PRISm. Both never- and ever-smokers aged ≥40 years who underwent computed tomography (CT) for lung cancer screening and spirometry were retrospectively and consecutively enrolled at three hospitals and a clinic. Emphysema subtypes were visually classified according to the Fleischner system. Air-trapping was assessed as the ratio of FVC to total lung capacity on CT (TLCCT). In 1046 never-smokers and 772 smokers with ≥10 pack-years, the prevalence of PRISm was 8.2% and 11.3%, respectively. The prevalence of PSE and CLE in smokers with PRISm was comparable to that in smokers with normal spirometry (PSE 43.7% versus 36.2%, p=1.00; CLE 46.0% versus 31.8%, p=0.21), but higher than that in never-smokers with PRISm (PSE 43.7% versus 1.2%, p<0.01; CLE 46% versus 4.7%, p<0.01) and lower than that in smokers with airflow limitation (PSE 43.7% versus 71.0%, p<0.01; CLE 46% versus 79.3%, p<0.01). The presence of CLE, but not PSE, was independently associated with reduced FVC/TLCCT in smokers with PRISm. Both PSE and CLE were common, but only CLE was associated with air-trapping in smokers with PRISm, suggesting different physiological roles of these emphysema subtypes. |
| first_indexed | 2024-03-13T06:53:10Z |
| format | Article |
| id | doaj.art-d4ca322f2fa5443f9548c6aeb6e5ad58 |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-03-13T06:53:10Z |
| publishDate | 2022-06-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-d4ca322f2fa5443f9548c6aeb6e5ad582023-06-07T13:30:09ZengEuropean Respiratory SocietyERJ Open Research2312-05412022-06-018210.1183/23120541.00063-202200063-2022The prevalence and physiological impacts of centrilobular and paraseptal emphysema on computed tomography in smokers with preserved ratio impaired spirometryYusuke Shiraishi0Takafumi Shimada1Naoya Tanabe2Kunihiko Terada3Ryo Sakamoto4Tomoki Maetani5Hiroshi Shima6Fumi Mochizuki7Tsuyoshi Oguma8Kaoruko Shimizu9Susumu Sato10Shigeo Muro11Nobuyuki Hizawa12Motonari Fukui13Hiroaki Iijima14Izuru Masuda15Toyohiro Hirai16 Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan Dept of Respiratory Medicine, Tsukuba Medical Center, Tsukuba, Japan Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan Terada Clinic, Respiratory Medicine and General Practice, Himeji, Japan Dept of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan Dept of Respiratory Medicine, Tsukuba Medical Center, Tsukuba, Japan Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan Dept of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan Dept of Pulmonary Medicine, University of Tsukuba, Tsukuba, Japan Respiratory Disease Center, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, Osaka, Japan Dept of Respiratory Medicine, Tsukuba Medical Center, Tsukuba, Japan Medical Examination Center, Takeda Hospital, Kyoto, Japan Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan Centrilobular emphysema (CLE) and paraseptal emphysema (PSE) are observed in smokers with preserved ratio impaired spirometry (PRISm, defined as the ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ≥0.7 and FEV1 <80%), but their prevalence and physiological impacts remain unestablished. This multicentre study aimed to investigate its prevalence and to test whether emphysema subtypes are differently associated with physiological impairments in smokers with PRISm. Both never- and ever-smokers aged ≥40 years who underwent computed tomography (CT) for lung cancer screening and spirometry were retrospectively and consecutively enrolled at three hospitals and a clinic. Emphysema subtypes were visually classified according to the Fleischner system. Air-trapping was assessed as the ratio of FVC to total lung capacity on CT (TLCCT). In 1046 never-smokers and 772 smokers with ≥10 pack-years, the prevalence of PRISm was 8.2% and 11.3%, respectively. The prevalence of PSE and CLE in smokers with PRISm was comparable to that in smokers with normal spirometry (PSE 43.7% versus 36.2%, p=1.00; CLE 46.0% versus 31.8%, p=0.21), but higher than that in never-smokers with PRISm (PSE 43.7% versus 1.2%, p<0.01; CLE 46% versus 4.7%, p<0.01) and lower than that in smokers with airflow limitation (PSE 43.7% versus 71.0%, p<0.01; CLE 46% versus 79.3%, p<0.01). The presence of CLE, but not PSE, was independently associated with reduced FVC/TLCCT in smokers with PRISm. Both PSE and CLE were common, but only CLE was associated with air-trapping in smokers with PRISm, suggesting different physiological roles of these emphysema subtypes.http://openres.ersjournals.com/content/8/2/00063-2022.full |
| spellingShingle | Yusuke Shiraishi Takafumi Shimada Naoya Tanabe Kunihiko Terada Ryo Sakamoto Tomoki Maetani Hiroshi Shima Fumi Mochizuki Tsuyoshi Oguma Kaoruko Shimizu Susumu Sato Shigeo Muro Nobuyuki Hizawa Motonari Fukui Hiroaki Iijima Izuru Masuda Toyohiro Hirai The prevalence and physiological impacts of centrilobular and paraseptal emphysema on computed tomography in smokers with preserved ratio impaired spirometry ERJ Open Research |
| title | The prevalence and physiological impacts of centrilobular and paraseptal emphysema on computed tomography in smokers with preserved ratio impaired spirometry |
| title_full | The prevalence and physiological impacts of centrilobular and paraseptal emphysema on computed tomography in smokers with preserved ratio impaired spirometry |
| title_fullStr | The prevalence and physiological impacts of centrilobular and paraseptal emphysema on computed tomography in smokers with preserved ratio impaired spirometry |
| title_full_unstemmed | The prevalence and physiological impacts of centrilobular and paraseptal emphysema on computed tomography in smokers with preserved ratio impaired spirometry |
| title_short | The prevalence and physiological impacts of centrilobular and paraseptal emphysema on computed tomography in smokers with preserved ratio impaired spirometry |
| title_sort | prevalence and physiological impacts of centrilobular and paraseptal emphysema on computed tomography in smokers with preserved ratio impaired spirometry |
| url | http://openres.ersjournals.com/content/8/2/00063-2022.full |
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