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Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease

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Published on: June 16, 2020

Suspected Interstitial Lung Disease in COPDGene Study.

Jonathan A Rose¹, Aravind A Menon¹, Takuya Hino²

¹Pulmonary and Critical Care Division.

American Journal of Respiratory and Critical Care Medicine

|August 5, 2022

Summary

Interstitial lung disease (ILD) in patients with interstitial lung abnormalities (ILA) is linked to worse health outcomes and higher mortality. Identifying suspected ILD is crucial for understanding its impact on lung function and patient prognosis.

Keywords:

interstitial lung abnormalities interstitial lung disease pulmonary fibrosis

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Area of Science:

Pulmonology
Radiology
Epidemiology

Background:

Interstitial lung abnormalities (ILA) on CT scans are linked to poor lung function and mortality.
The specific contribution of interstitial lung disease (ILD) within ILA to these adverse outcomes remains unclear.

Purpose of the Study:

To determine the prevalence and risk factors of suspected ILD in individuals with ILA.
To assess the association of suspected ILD with clinical outcomes, including lung function, exacerbations, and mortality.

Main Methods:

The COPDGene study cohort was used, defining suspected ILD as ILA plus fibrosis, reduced FVC, or reduced DLCO.
Multivariable regression models analyzed associations with quality of life (SGRQ), exercise capacity (6MWT), oxygen use, exacerbations, and mortality.

Main Results:

5% of participants had suspected ILD, and 5% had ILA without suspected ILD.
Suspected ILD was associated with worse SGRQ scores, reduced 6MWT distance, increased oxygen use, more severe exacerbations, and higher mortality compared to ILA alone.
Risk factors for suspected ILD included Black race and smoking history.

Conclusions:

Suspected ILD affects half of individuals with ILA in the COPDGene cohort.
Suspected ILD is significantly associated with decrements in exercise capacity, increased symptoms, higher rates of oxygen use and exacerbations, and increased mortality.