Tetsuro Araki1, Mizuki Nishino2, Oscar E Zazueta3, Wei Gao4, Josée Dupuis5, Yuka Okajima2, Jeanne C Latourelle6, Ivan O Rosas3, Takamichi Murakami7, George T O'Connor8, George R Washko3, Gary M Hunninghake3, Hiroto Hatabu2. 1. Department of Radiology, Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02215, USA; Department of Radiology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan. Electronic address: taraki@partners.org. 2. Department of Radiology, Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02215, USA. 3. The Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 4. Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA. 5. Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA; The National Heart Lung and Blood Institute's Framingham Heart Study, Framingham, MA, USA. 6. Department of Medicine and Neurology, Boston University School of Medicine, Boston, MA, USA. 7. Department of Radiology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan. 8. The National Heart Lung and Blood Institute's Framingham Heart Study, Framingham, MA, USA; Pulmonary Center and Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
Abstract
OBJECTIVE: To investigate the prevalence and distribution of paraseptal emphysema on chest CT images in the Framingham Heart Study (FHS) population, and assess its impact on pulmonary function. Also pursued was the association with interstitial lung abnormalities. MATERIALS AND METHODS: We assessed 2633 participants in the FHS for paraseptal emphysema on chest CT. Characteristics of the participants, including age, sex, smoking status, clinical symptoms, and results of pulmonary function tests, were compared between those with and without paraseptal emphysema. The association between paraseptal emphysema and interstitial lung abnormalities was investigated. RESULTS: Of the 2633 participants, 86 (3%) had pure paraseptal emphysema (defined as paraseptal emphysema with no other subtypes of emphysema other than paraseptal emphysema or a very few centrilobular emphysema involved) in at least one lung zone. The upper zone of the lungs was almost always involved. Compared to the participants without paraseptal emphysema, those with pure paraseptal emphysema were significantly older, and were more frequently male and smokers (mean 64 years, 71% male, mean 36 pack-years, P<0.001) and had significantly decreased FEV1/FVC% (P=0.002), and diffusion capacity of carbon monoxide (DLCO) (P=0.002). There was a significant association between pure paraseptal emphysema and interstitial lung abnormalities (P<0.001). CONCLUSIONS: The prevalence of pure paraseptal emphysema was 3% in the FHS population, predominantly affects the upper lung zone, and contributes to decreased pulmonary function. Cigarette smoking, aging, and male gender were the factors associated with the presence of paraseptal emphysema. Significant association between paraseptal emphysema and interstitial lung abnormalities was observed.
OBJECTIVE: To investigate the prevalence and distribution of paraseptal emphysema on chest CT images in the Framingham Heart Study (FHS) population, and assess its impact on pulmonary function. Also pursued was the association with interstitial lung abnormalities. MATERIALS AND METHODS: We assessed 2633 participants in the FHS for paraseptal emphysema on chest CT. Characteristics of the participants, including age, sex, smoking status, clinical symptoms, and results of pulmonary function tests, were compared between those with and without paraseptal emphysema. The association between paraseptal emphysema and interstitial lung abnormalities was investigated. RESULTS: Of the 2633 participants, 86 (3%) had pure paraseptal emphysema (defined as paraseptal emphysema with no other subtypes of emphysema other than paraseptal emphysema or a very few centrilobular emphysema involved) in at least one lung zone. The upper zone of the lungs was almost always involved. Compared to the participants without paraseptal emphysema, those with pure paraseptal emphysema were significantly older, and were more frequently male and smokers (mean 64 years, 71% male, mean 36 pack-years, P<0.001) and had significantly decreased FEV1/FVC% (P=0.002), and diffusion capacity of carbon monoxide (DLCO) (P=0.002). There was a significant association between pure paraseptal emphysema and interstitial lung abnormalities (P<0.001). CONCLUSIONS: The prevalence of pure paraseptal emphysema was 3% in the FHS population, predominantly affects the upper lung zone, and contributes to decreased pulmonary function. Cigarette smoking, aging, and male gender were the factors associated with the presence of paraseptal emphysema. Significant association between paraseptal emphysema and interstitial lung abnormalities was observed.
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