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Phenotyping COPD exacerbations using imaging and blood-based biomarkers.
Nawaf M Alotaibi1,2, Virginia Chen1,3,4, Zsuzsanna Hollander1,3,4
1Centre for Heart Lung Innovation, James Hogg Research Centre, St Paul's Hospital, Vancouver, BC, Canada.
International Journal of Chronic Obstructive Pulmonary Disease
|February 2, 2018
Summary
Blood tests C-reactive protein (CRP) and N-terminal prohormone brain natriuretic peptide (NT-proBNP) can help phenotype acute exacerbations of chronic obstructive pulmonary disease (AECOPD). These biomarkers show associations with imaging findings, aiding in diagnosis and targeted therapies.
Area of Science:
- Pulmonary Medicine
- Radiology
- Biomarker Discovery
Background:
- Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have diverse causes.
- Accurate phenotyping of AECOPD is crucial for effective treatment.
- Imaging and blood tests are used in managing AECOPD.
Purpose of the Study:
- To phenotype COPD exacerbations using chest imaging (CXR, CT).
- To evaluate blood tests (CRP, NT-proBNP) as diagnostic biomarkers for AECOPD.
- To determine associations between imaging findings and blood biomarkers.
Main Methods:
- 309 hospitalized AECOPD patients were assessed.
- Chest X-rays (CXRs) and CT scans were interpreted by blinded radiologists.
- Statistical analyses (ANOVA, Spearman's correlation, logistic regression) were performed.
Main Results:
- NT-proBNP correlated with cardiac enlargement, pulmonary edema, and pleural effusion on CXR and CT.
- CRP correlated with consolidation, ground glass opacities, and pleural effusion on CT.
- A CRP cutoff of 11.5 mg/L showed 91% sensitivity for CT-confirmed consolidation.
Conclusions:
- Elevated CRP may suggest pneumonia; elevated NT-proBNP may indicate cardiac dysfunction.
- These biomarkers aid in more accurate AECOPD phenotyping.
- Biomarker-guided approaches may lead to more precise AECOPD therapies.
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