The Senile Lung

Verbeken, Erik; Cauberghs, M.; Mertens, Ingrid; Clement, Jacques; Lauweryns, Joseph M.; Woestijne, K. P. Van de

doi:10.1378/chest.101.3.793

Cited by 231 publications

(66 citation statements)

References 15 publications

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“…(3,5) Interestingly, the age-related changes are remarkably homogeneous, as opposed to the irregular distribution of airspace enlargement in emphysema. (5) The EI values observed in our cohort of patients were higher than were those reported in a study involving single-slice CT (22) and lower than were those reported in a study involving HRCT.…”

Section: Resultsmentioning

confidence: 99%

“…(2) Degeneration of elastic fibers in the respiratory bronchioles, alveolar ducts, and alveoli occurs as part of the natural aging process, usually in individuals over 50 years of age. (3,4) As a consequence, the density of lung parenchyma diminishes, because the alveolar ducts become enlarged and the alveoli become shallower. (4) These changes have been designated "senile emphysema" (3,4) and correlate with stage I COPD, which is found in approximately 35% of "healthy" elderly nonsmokers.…”

Section: Introductionmentioning

confidence: 99%

“…(3,4) As a consequence, the density of lung parenchyma diminishes, because the alveolar ducts become enlarged and the alveoli become shallower. (4) These changes have been designated "senile emphysema" (3,4) and correlate with stage I COPD, which is found in approximately 35% of "healthy" elderly nonsmokers. (5) Because pulmonary emphysema is defined on an anatomical basis, CT is currently the modality of choice for an accurate and noninvasive assessment of in vivo pathological changes.…”

Section: Introductionmentioning

confidence: 99%

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Índice de enfisema pulmonar em coorte de pacientes sem doença pulmonar conhecida: influência da idade

et al. 2012

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Objective: To investigate the effects of age on pulmonary emphysema, based on the values of the emphysema index (EI) in a cohort of patients who had never smoked and who had no recognizable lung disease. Methods: We reviewed the CT scans, reported as normal, of 315 patients. Exclusion criteria were a history of smoking, cardiorespiratory disease, and exposure to drugs that could cause lung disease. From this cohort, we selected 32 patients (16 men and 16 women), matched for gender and body mass index, who were divided equally into two groups by age (< 50 years and ≥ 50 years). We quantified emphysema using a computer program specific to that task. The EI was calculated with a threshold of −950 HU. We also evaluated total lung volume (TLV) and mean lung density (MLD). Results: The overall means for TLV, MLD, and EI were 5,027 mL, −827 HU, and 2.54%, respectively. Mean values in the older and younger groups, respectively, were as follows: for TLV, 5,229 mL vs. 4,824 mL (p > 0.05); for MLD, −846 HU vs. −813 HU (p < 0.04); and for EI, 3.30% vs. 1.28% (p < 0.001). Significant correlations were found between EI and age (r = 0.66; p = 0.001), EI and TLV (r = 0.58; p = 0.001), and EI and MLD (r = −0.67; p < 0.001). The predicted EI per age was defined by the regression equation (r 2 = 0.43): p50(EI) = 0.049 × age − 0.5353. Conclusions: It is important to consider the influence of age when quantifying emphysema in patients over 50 years of age. Based on the regression analysis, EI values of 2.6%, 3.5%, and 4.5% can be considered normal for patients 30, 50, and 70 years of age, respectively. Keywords: Pulmonary emphysema; Tomography, spiral computed; Aging; Pulmonary disease, chronic obstructive. ResumoObjetivo: Investigar os efeitos da idade no enfisema pulmonar, com base nos valores do índice de enfisema (IE) em uma coorte de pacientes que nunca fumou e que não possuía doença pulmonar conhecida. Métodos: Foram revisados exames de TC, considerados normais, de 315 pacientes. Tabagismo, doenças cardiorrespiratórias e exposição a drogas que poderiam causar doença pulmonar foram critérios de exclusão. Dessa coorte, selecionamos 32 pacientes (16 homens e 16 mulheres), igualmente divididos em dois grupos (idade < 50 anos e idade ≥ 50 anos), que foram pareados por gênero e índice de massa corpórea. Realizou-se a quantificação do enfisema utilizando um programa específico. O IE foi calculado com um limiar de −950 UH. O volume pulmonar total (VPT) e a densidade pulmonar média (DPM) também foram avaliados. Resultados: As médias gerais de VPT, DPM e IE foram 5.027 mL, −827 UH e 2,54%, respectivamente. A comparação entre os mais velhos e os mais novos mostrou as seguintes médias: VPT (5.229 mL vs. 4.824 mL; p > 0,05); DPM (−846 UH vs. −813 UH; p < 0,04) e IE (3,30% vs. 1,28%; p < 0,001). Houve correlações significativas entre IE e idade (r = 0,66; p = 0,001), IE e VPT (r = 0,58; p = 0,001) e IE e DPM (r = −0,67; p < 0,001). O IE previsto por idade foi definido através da equação de regressão (r 2 = 0,43): p50(IE) = 0,049 × i...

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Índice de enfisema pulmonar em coorte de pacientes sem doença pulmonar conhecida: influência da idade

et al. 2012

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“…After the fourth decade of life, part of the elastic fibers in the respiratory bronchioles and alveoli degenerate, their complacency therefore decreasing. (38) These changes are more pronounced around the alveolar ducts. Consequently, there is alveolar duct dilatation, followed by air space enlargement.…”

Section: Aging-related Changes In Radiological Findings In the Mediasmentioning

confidence: 96%

“…This related phenomenon that has been designated "senile emphysema" (Figure 3). (38) Aging-related parenchymal changes are caused by reduced blood flow from the systemic circulation through the bronchial arteries, as well as by the aforementioned quantitative/ The chest and aging: radiological findings pulmonary hypertension (a clinical manifestation of mild vascular sclerosis) that can redistribute pulmonary flow cranially and be mistaken for early signs of cardiac decompensation. (41)(42)(43) The major determinants of static lung volumes are chest wall compliance and lung parenchymal compliance.…”

Section: Aging-related Changes In Radiological Findings In the Lung Pmentioning

confidence: 99%

O tórax e o envelhecimento: manifestações radiológicas

Hochhegger¹,

Meirelles

Irion

et al. 2012

J. bras. pneumol.

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In the elderly (conventionally defined as individuals ≥ 60 years of age), it is often difficult to establish what normality is, because of the numerous anatomical and physiological modifications that occur during the aging process. As a result, the greatest challenge is to differentiate between the normal aging process and the onset of disease. Healthy elderly people commonly present borderline findings on chest imaging. We systematically reviewed the medical literature on the subject, covering the period between 1950 and 2011, including articles in Portuguese, English, French, Italian, and Spanish. We searched the PubMed, LILACS, and SciELO databases, using the search terms "age", "aging", "lung", "thorax", "chest", "X-ray", "radiography", "pulmonary", and "computed tomography"-as well as their corresponding translations-in various combinations. We included only original or review articles on aging-related chest imaging findings. In broad terms, aging results in physiological modifications that must be recognized so as not to be erroneously interpreted as pathological.Keywords: Aging; Thorax; Lung; Diagnostic imaging. ResumoNos idosos (convencionalmente definidos como indivíduos com idade ≥ de 60 anos), é muitas vezes difícil estabelecer o que é normal devido a inúmeras modificações anatômicas e fisiológicas que ocorrem durante o processo de envelhecimento. Como resultado, o principal problema consiste em diferenciar o ponto em que o envelhecimento é normal daquele no qual a doença começa. Os achados radiológicos do tórax de pessoas idosas sadias são comumente limítrofes. Revisamos sistematicamente a literatura médica sobre o assunto, abrangendo o período entre 1950 e 2011, incluindo artigos em português, inglês, francês, italiano e espanhol. A busca foi feita através das bases de dados PubMed, LILACS e SciELO, utilizando os seguintes termos: age, aging, lung, thorax, chest, X-ray, radiography, pulmonary, computed tomography e suas traduções correspondentes, em combinações variadas. Os critérios de inclusão foram artigos originais e de revisão de achados radiológicos no tórax relacionados ao envelhecimento. Em linhas gerais, o envelhecimento resulta em modificações fisiológicas que devem ser reconhecidas de forma a não serem erroneamente interpretadas como patologias.Descritores: Envelhecimento; Tórax; Pulmão; Diagnóstico por imagem.* Study carried out at the

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Stereological methods: A new approach in the assessment of pulmonary emphysema

Heemskerk-Gerritsen

Dijkman

Have-Opbroek

1996

Microsc. Res. Tech.

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In order to develop a reliable and sensitive method for studying the development and progression of pulmonary emphysema, we compared stereological indices with the usual index for grade of emphysema, i.e., the mean linear intercept (Lm), in elastase‐induced emphysema in mice. The Lm and stereological indices, including volumes of total lung tissue (V(lt)), airspaces (V(air)), and surface area of alveolar walls (S(alv)), were determined in 5‐μm, H&E‐stained, paraffin‐embedded lung sections from elastase‐ (n = 7) or saline‐treated (n = 8) mice. The indices were measured by point counting, using Cavalieri's principle (V(lt) and V(air)) or by counting intersections of alveolar walls with test lines of a known length (S(alv) and Lm). Elastase treatment resulted in a significant increase of Lm and of V(air), both indicating airspace enlargement, and in a significant decrease of V(lt) and S(alv), indicating destruction of alveolar walls. Between each of the stereological indices and the Lm, significant correlations were found when all lungs were included, but not when the emphysematous lungs were considered separately. We conclude that stereological methods can be powerful morphometric tools for studying pulmonary emphysema development and progression, since they give information not only about the grade of airspace enlargement but also about the grade of destruction of alveolar walls. Based on this unique property, stereological methods also allow a distinction between pulmonary emphysema and unrelated conditions with dilatation of airspaces only. © 1996 Wiley‐Liss, Inc.

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The Senile Lung

Cited by 231 publications

References 15 publications

Índice de enfisema pulmonar em coorte de pacientes sem doença pulmonar conhecida: influência da idade

Índice de enfisema pulmonar em coorte de pacientes sem doença pulmonar conhecida: influência da idade

O tórax e o envelhecimento: manifestações radiológicas

Stereological methods: A new approach in the assessment of pulmonary emphysema

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