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Structural Predictors of Lung Function Decline in Young Smokers with Normal Spirometry.
Andrew I Ritchie1,2, Gavin C Donaldson1, Eric A Hoffman3,4
1National Heart and Lung Institute, Imperial College London, London, United Kingdom.
American Journal of Respiratory and Critical Care Medicine
|January 4, 2024
Summary
Early lung damage in smokers is detectable via CT scans, even with normal lung function. These structural changes predict future lung function decline in chronic obstructive pulmonary disease (COPD).
Area of Science:
- Pulmonary Medicine
- Radiology
- Respiratory Health
Background:
- Chronic obstructive pulmonary disease (COPD) often diagnosed after significant lung damage.
- Early detection of structural changes in smokers is crucial for understanding COPD progression.
Purpose of the Study:
- To investigate early structural changes in the lungs of smokers using quantitative computed tomography (QCT).
- To determine if these early structural changes correlate with lung function decline over time.
Main Methods:
- Recruited 431 current smokers and 67 non-smoking controls.
- Utilized COPD Assessment Test (CAT), spirometry, and QCT scans at baseline.
- Followed 368 participants for a median of 32 months to assess FEV1 decline.
Main Results:
- Smokers showed increased QCT markers of small airway disease, ground-glass opacification, and altered vasculature compared to controls.
- These QCT abnormalities, along with higher CAT scores, were associated with faster FEV1 decline.
- Radiological abnormalities were present in young smokers with initially normal lung function.
Conclusions:
- Structural lung abnormalities are detectable early in smokers, preceding significant lung function loss.
- QCT findings are independent predictors of FEV1 decline in early COPD.
- Early radiological changes serve as markers for COPD progression in smokers.
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