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High Airway-To-Vessel Volume Ratio and Visual Bronchiectasis Are Associated With Exacerbations in COPD
Nobuyasu Wakazono1, Kaoruko Shimizu1, Naoya Tanabe2
1Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan.
Respirology (Carlton, Vic.)
|September 1, 2025
Summary
An increased airway to lung vasculature ratio (AVR) is linked to more frequent exacerbations in chronic obstructive pulmonary disease (COPD) patients. This finding suggests AVR is a new CT scan predictor for COPD exacerbations.
Area of Science:
- Pulmonary Medicine
- Radiology
- Cardiovascular Imaging
Background:
- The relationship between airway and lung vasculature volume mismatch and exacerbations in chronic obstructive pulmonary disease (COPD) remains unclear.
- Computed tomography (CT) is used to assess airway and vascular structures.
Purpose of the Study:
- To investigate the association between an elevated airway to lung vasculature ratio (AVR) and COPD exacerbations.
- To determine if AVR predicts exacerbations independently of bronchiectasis and extrapulmonary vasculature.
Main Methods:
- Utilized CT scans from two cohorts (Hokkaido COPD Cohort Study and Kyoto University cohort) to measure airway and vascular indices, including the AVR.
- Employed Kaplan-Meier analysis and multivariable Cox proportional hazards models to assess the time to first exacerbation over a 5-year follow-up.
Main Results:
- A higher AVR was significantly associated with a shorter time to first exacerbation in COPD patients.
- This association persisted regardless of the modified Reiff (mReiff) score for bronchiectasis and the pulmonary artery to aorta diameter ratio (PA/Ao).
Conclusions:
- The airway to lung vasculature ratio (AVR) is a novel CT-derived predictor of exacerbations in COPD.
- AVR provides complementary information to existing markers like mReiff score and PA/Ao for assessing exacerbation risk.
Keywords:
bronchiectasischronic obstructive pulmonary diseasecomputed tomographyexacerbationpulmonary blood vesselMore Related Videos
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