These data also show that more subjects with MP, looking at two different thresholds (MP+ versus-and MP ≥ 4 versus < 4) had CB using two different definitions. Except for %emphysema, findings were similarly significant in the MP ≥ 4 group compared to the MP < 4 group. Percent emphysema, percent gas trapping, airway wall thickness, exacerbation frequency and severe exacerbation frequency were all significantly higher in the MP+ group (p < 0.05 for all). Dyspnea, health-related quality of life, and lung function were worse in the MP+ group (p < 0.05 for all). Similar values were found when comparing those with and without SGRQ CB (38.8 vs. 10.6% of the classic CB group had an MP score ≥ 4 compared to 5.0% of those without classic CB (p < 0.0001). In those with classic CB (n = 519), 36.9% of them had MP compared to 29.7% of those without classic CB (n = 1570, p = 0.002). In the MP ≥ 4 group, the differences were more significant with 57.7% and 41.4% of the subjects having SGRQ CB and classic CB, respectively, compared to 27.6% and 23.8% of the MP < 4 group. 22.9%) or the Saint George’s Respiratory Questionnaire (SGRQ) definition (cough and phlegm for the past 4 weeks almost every day or several days a week, 39.1 vs. Compared to the MP− group, the MP+ group was more likely to have CB by either the classic definition (cough and phlegm for at least 3 months/year for 2 consecutive years, 29.2 vs. 658 (31.5%) subjects had mucus plugging on CT scan. Subject characteristics are presented in Table 1. Covariates included demographics, lung function, smoking, and radiologic parameters. Odds ratios for CB were calculated with MP scores using multivariable logistic regression models. We compared subject characteristics between groups with either an unpaired t test or Chi-square test. Additionally, based on prior research in asthma showing that mucus plugging of ≥ 4 segments was associated with worse lung function, we divided subjects into those with an MP score ≥ 4 and compared them to those with an MP score < 4. We divided subjects into those with at least one airway plugged with mucus (MP+) and those without MP (MP−). If a CT scan required more than one reading, the final MP score was an average of the scores from two or three readers. An MP score was generated for each CT scan as an aggregation of the number of bronchopulmonary segments with MP (0–18). In a standardized fashion, all airway paths were examined in each out of 18 bronchopulmonary segments of both lungs. Major airways such as the trachea, main stem and lobar bronchi were excluded. A mucus plug was defined as an opacity that completely occludes the lumen, regardless of the airway size, orientation or generation. Measurement of MP has been described previously. Briefly, this cohort was comprised of African American and non-Hispanic White current and former smokers (≥ 10 pack year history) 45–80 years of age with COPD. We analyzed 2089 randomly chosen subjects from the Genetic Epidemiology Study of COPD (COPDGene). We hypothesized that those with MP are more likely to have CB compared to those without MP. How it relates to CB in smokers with COPD is unclear. Mucus plugging (MP) on CT scan has been associated with decreased lung function, worse health-related quality of life, and amount of emphysema in Chronic Obstructive Pulmonary Disease (COPD). The hallmark of CB is mucus overproduction and goblet cell hyperplasia. Chronic bronchitis (CB) is associated with more dyspnea, increased respiratory exacerbations, reduced exercise capacity, and mortality.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |