Characteristics of COPD in never-smokers and ever-smokers in the general population: results from the CanCOLD study

Tan, Wan C.; Sin, Don D.; Bourbeau, Jean; Hernández, Paul; Chapman, Kenneth R.; Cowie, Robert L.; FitzGerald, J. Mark; Marciniuk, Darcy; Maltais, François; Buist, A. Sonia; Road, Jeremy; Hogg, James C.; Kirby, Miranda; Coxson, Harvey O.; Hague, Cameron; Leipsic, Jonathon; O’Donnell, Denis E.; Aaron, Shawn D.

doi:10.1136/thoraxjnl-2015-206938

Cited by 198 publications

(153 citation statements)

References 33 publications

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“…Participants between 45 and 90 years from the multisite, population-based CanCOLD study were evaluated [12,13] ; the sites include Vancouver, Calgary, Ottawa, Quebec City, Montreal, Toronto, Halifax, Kingston, and Saskatoon. Ethics approval was obtained from the institutional review board at each CanCOLD study site.…”

Section: Participantsmentioning

confidence: 99%

A Novel Method of Estimating Small Airway Disease Using Inspiratory-to-Expiratory Computed Tomography

Kirby

Yin²,

Tschirren³

et al. 2017

Respiration

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Background: Disease accumulates in the small airways without being detected by conventional measurements. Objectives: To quantify small airway disease using a novel computed tomography (CT) inspiratory-to-expiratory approach called the disease probability measure (DPM) and to investigate the association with pulmonary function measurements. Methods: Participants from the population-based CanCOLD study were evaluated using full-inspiration/full-expiration CT and pulmonary function measurements. Full-inspiration and full-expiration CT images were registered, and each voxel was classified as emphysema, gas trapping (GasTrap) related to functional small airway disease, or normal using two classification approaches: parametric response map (PRM) and DPM (VIDA Diagnostics, Inc., Coralville, IA, USA). Results: The participants included never-smokers (n = 135), at risk (n = 97), Global Initiative for Chronic Obstructive Lung Disease I (GOLD I) (n = 140), and GOLD II chronic obstructive pulmonary disease (n = 96). PRM_GasTrap and DPM_GasTrap measurements were significantly elevated in GOLD II compared to never-smokers (p < 0.01) and at risk (p < 0.01), and for GOLD I compared to at risk (p < 0.05). Gas trapping measurements were significantly elevated in GOLD II compared to GOLD I (p < 0.0001) using the DPM classification only. Overall, DPM classified significantly more voxels as gas trapping than PRM (p < 0.0001); a spatial comparison revealed that the expiratory CT Hounsfield units (HU) for voxels classified as DPM_GasTrap but PRM_Normal (PRM_Normal- DPM_GasTrap = -785 ± 72 HU) were significantly reduced compared to voxels classified normal by both approaches (PRM_Normal-DPM_Normal = -722 ± 89 HU; p < 0.0001). DPM and PRM_GasTrap measurements showed similar, significantly associations with forced expiratory volume in 1 s (FEV₁) (p < 0.01), FEV₁/forced vital capacity (p < 0.0001), residual volume/total lung capacity (p < 0.0001), bronchodilator response (p < 0.0001), and dyspnea (p < 0.05). Conclusion: CT inspiratory-to-expiratory gas trapping measurements are significantly associated with pulmonary function and symptoms. There are quantitative and spatial differences between PRM and DPM classification that need pathological investigation.

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Section: Participantsmentioning

confidence: 99%

A Novel Method of Estimating Small Airway Disease Using Inspiratory-to-Expiratory Computed Tomography

Kirby

Yin²,

Tschirren³

et al. 2017

Respiration

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“…Smoking is the most frequent cause of COPD, although there are other risk factors such as exposure to occupational dust, air pollution and biomass burning. 20 We observed that 42% of our patients reported exposure to wood stoves.…”

Section: Results As N (%) or ± Sd (Min-max)mentioning

confidence: 83%

“…18 COPD underdiagnosis results in late recognition of the disease and in later stages. 19,20 Early detection of airflow limitation and smoking cessation intervention may delay the decline of lung function, reduce COPD symptoms, and improve the patient's quality of life.…”

Section: Discussionmentioning

confidence: 99%

Hospitalization due to exacerbation of COPD: "Real-life" outcomes

Camargo

Castellano²,

Ferreira³

et al. 2017

Rev. Assoc. Med. Bras.

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“…More specifically, those with low TLCO ventilated in excess of the prevailing metabolic demand, i. e. they had poorer exertional ventilatory efficiency (figure 1a). Early emphysema [5], ventilation distribution heterogeneity [10] and pulmonary microvascular disease [6], in different combinations, could explain these findings, particularly in subjects susceptible to the deleterious effects of smoking. The physiological basis of these derangements likely stem from increased dead space per se rather than a small tidal volume [11].…”

Section: To the Editormentioning

confidence: 99%

“…It is noteworthy that a low TLCO has been linked to structural markers of early emphysema [5] and pulmonary microvascular abnormalities [6] in smokers with airflow limitation but preserved forced expiratory volume in 1 s (FEV1), i.e. Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 1.…”

Section: To the Editormentioning

confidence: 99%

Impaired exercise ventilatory efficiency in smokers with low transfer factor but normal spirometry

et al. 2017

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Characteristics of COPD in never-smokers and ever-smokers in the general population: results from the CanCOLD study

Abstract: NCT00920348 (ClinicalTrials.gov); study ID number: IRO-93326.

Cited by 198 publications

References 33 publications

A Novel Method of Estimating Small Airway Disease Using Inspiratory-to-Expiratory Computed Tomography

A Novel Method of Estimating Small Airway Disease Using Inspiratory-to-Expiratory Computed Tomography

Hospitalization due to exacerbation of COPD: "Real-life" outcomes

Impaired exercise ventilatory efficiency in smokers with low transfer factor but normal spirometry

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