TY - JOUR
T1 - Poor symptom control is associated with reduced CT scan segmental airway lumen area in smokers with asthma
AU - Thomson, Neil C.
AU - Chaudhuri, Rekha
AU - Spears, Mark
AU - Messow, Claudia Martina
AU - MacNee, William
AU - Connell, Martin
AU - Murchison, John T.
AU - Sproule, Michael
AU - McSharry, Charles
N1 - Funding Information:
FUNDING/SUPPORT: This work was funded by an award [INF-GU-090] from the Translational Medicine Research Collaboration, a consortium made up of the Universities of Glasgow, Edinburgh, Aberdeen, and Dundee; the four associated National Health Service (NHS) Health Boards (Greater Glasgow and Clyde, Lothian, Grampian, and Tayside); Scottish Enterprise; and Pfizer (formerly Wyeth). This study was also supported financially by NHS Research Scotland (NRS) through the Scottish Primary Care Research Network.
Publisher Copyright:
© 2015 American College of Chest Physicians.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - BACKGROUND: Cigarette smoking is associated with worse symptoms in asthma and abnormal segmental airways in healthy subjects. We tested the hypothesis that current symptom control in smokers with asthma is associated with altered segmental airway dimensions measured by CT scan. METHODS: In 93 subjects with mild, moderate, and severe asthma (smokers and never smokers), we recorded Asthma Control Questionnaire-6 (ACQ-6) score, spirometry (FEV1; forced expiratory flow rate, midexpiratory phase [FEF25%-75%]), residual volume (RV), total lung capacity (TLC), and CT scan measures of the right bronchial (RB) and left bronchial (LB) segmental airway dimensions (wall thickness, mm; lumen area, mm2) in the RB3/LB3, RB6/LB6, and RB10/LB10 (smaller) airways. RESULTS: The CT scan segmental airway (RB10 and LB10) lumen area was reduced in smokers with asthma compared with never smokers with asthma; RB10, 16.6 mm2 (interquartile range, 12.4-19.2 mm2) vs 19.6 mm2 (14.7-24.2 mm2)(P = .01); LB10, 14.8 mm2 (12.1-19.0 mm2) vs 19.9 mm2 (14.5-25.0 mm2)(P = .003), particularly in severe disease, with no differences in wall thickness or in larger airway (RB3 and LB3) dimensions. In smokers with asthma, a reduced lumen area in fifth-generation airways (RB10 or LB10) was associated with poor symptom control (higher ACQ-6 score)(-0.463 [-0.666 to -0.196], P = .001, and -0.401 [-0.619 to -0.126], P = .007, respectively) and reduced postbronchodilator FEF25%-75% (0.521 [0.292-0.694], P < .001, and [0.471 [0.236-0.654], P = .001, respectively) and higher RV/TLC %. CONCLUSIONS: The CT scan segmental airway lumen area is reduced in smokers with asthma compared with never smokers with asthma, particularly in severe disease, and is associated with worse current symptom control and small airway dysfunction.
AB - BACKGROUND: Cigarette smoking is associated with worse symptoms in asthma and abnormal segmental airways in healthy subjects. We tested the hypothesis that current symptom control in smokers with asthma is associated with altered segmental airway dimensions measured by CT scan. METHODS: In 93 subjects with mild, moderate, and severe asthma (smokers and never smokers), we recorded Asthma Control Questionnaire-6 (ACQ-6) score, spirometry (FEV1; forced expiratory flow rate, midexpiratory phase [FEF25%-75%]), residual volume (RV), total lung capacity (TLC), and CT scan measures of the right bronchial (RB) and left bronchial (LB) segmental airway dimensions (wall thickness, mm; lumen area, mm2) in the RB3/LB3, RB6/LB6, and RB10/LB10 (smaller) airways. RESULTS: The CT scan segmental airway (RB10 and LB10) lumen area was reduced in smokers with asthma compared with never smokers with asthma; RB10, 16.6 mm2 (interquartile range, 12.4-19.2 mm2) vs 19.6 mm2 (14.7-24.2 mm2)(P = .01); LB10, 14.8 mm2 (12.1-19.0 mm2) vs 19.9 mm2 (14.5-25.0 mm2)(P = .003), particularly in severe disease, with no differences in wall thickness or in larger airway (RB3 and LB3) dimensions. In smokers with asthma, a reduced lumen area in fifth-generation airways (RB10 or LB10) was associated with poor symptom control (higher ACQ-6 score)(-0.463 [-0.666 to -0.196], P = .001, and -0.401 [-0.619 to -0.126], P = .007, respectively) and reduced postbronchodilator FEF25%-75% (0.521 [0.292-0.694], P < .001, and [0.471 [0.236-0.654], P = .001, respectively) and higher RV/TLC %. CONCLUSIONS: The CT scan segmental airway lumen area is reduced in smokers with asthma compared with never smokers with asthma, particularly in severe disease, and is associated with worse current symptom control and small airway dysfunction.
UR - http://www.scopus.com/inward/record.url?scp=84924859491&partnerID=8YFLogxK
U2 - 10.1378/chest.14-1119
DO - 10.1378/chest.14-1119
M3 - Article
C2 - 25356950
AN - SCOPUS:84924859491
SN - 0012-3692
VL - 147
SP - 735
EP - 744
JO - Chest
JF - Chest
IS - 3
ER -