COPD progressors vs. non-progressors: 10-year change in Bronchus-Artery ratios & mucus plugs

Abstract

Rationale: Bronchial wall thickening and mucus plugs (MP) can play a role in progressive airflow obstruction in COPD. Aims: to identify bronchial markers and MP in COPD patients that predict loss of FEV1/FVC over a 10-year period. Methods: A subset of 280 COPDGene subjects. Groups: based on GOLD-stage at baseline and 10-year follow-up, matched by age, gender and high-risk subtype. Controls: GOLD 0 remaining in GOLD 0 (n=38) and GOLD 2 remaining in GOLD 2 (n=43). Progressors: GOLD 0-2 or PRISm progressing to GOLD 3 or 4 (n=199). LungQ (Thirona, Netherlands) was used to compute bronchus-artery (BA) ratios of the inner and outer bronchus diameter and wall thickness ratios against the adjacent artery (Bin/A, Bout/A, Bwt/A), and between the bronchial wall area and outer area (Bwa/Boa), showing median (IQR) across segmental generations 1-6. The % of subjects with ≥1 detected MP was noted. Results: Baseline: GOLD 0 group had lower Bwt/A, and Bwa/Boa than the other groups. Between GOLD 2 control and progressor groups there were only insignificant differences. MP prevalence was highest in the progressor group. Longitudinally, the progressors declined in Bin/A from 0.91(0.21) to 0.83(0.22), and in number of BA-pairs measured from 260.7(73.2) to 198.5(67.2) and increased in Bwt/A from 0.25(0.08) to 0.28(0.08), and in Bwa/Boa from 0.38(0.11) to 0.44(0.12). MP prevalence increased from 27% to 50%, while it remained stable in the control group Conclusions: Baseline airway dimensions and MP differed between GOLD 0 and GOLD 2, but not between GOLD 2 progressors and non-progressors. COPD progression was associated with an increase in wall thickness, decrease in bronchial inner diameter and more mucus plugs.

Authors 6

1. Tjeerd van der Veer Aachen

   Leiden University Medical Center

   Affiliation as printed

   1Leiden University Medical Center, Leiden, Netherlands

2. Rudolfs Latisenko
   Affiliation as printed

   2Thirona, Nijmegen, Netherlands

3. Harm A.W.M. Tiddens
   Affiliation as printed

   2Thirona, Nijmegen, Netherlands

4. Jean Paul Charbonnier
   Affiliation as printed

   2Thirona, Nijmegen, Netherlands

5. David R. Lynch

   National Jewish Health

   Affiliation as printed

   3National Jewish Health, Denver, United States

6. James D. Crapo

   National Jewish Health

   Affiliation as printed

   3National Jewish Health, Denver, United States