Department of Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr. 5, Munich 80336, Germany.
Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ludwig-Maximilians-Universität München, Munich, Germany.
Ther Adv Respir Dis. 2023 Jan-Dec;17:17534666221148663. doi: 10.1177/17534666221148663.
Chest computed tomography (CT) is increasingly used for phenotyping and monitoring of patients with COPD. The aim of this work was to evaluate the association of Pi10 as a measure of standardized airway wall thickness on CT with exacerbations, mortality, and response to triple therapy.
Patients of GOLD grades 1-4 of the COSYCONET cohort with prospective CT scans were included. Pi10 was automatically computed and analyzed for its relationship to COPD severity, comorbidities, lung function, respiratory therapy, and mortality over a 6-year period, using univariate and multivariate comparisons.
We included = 433 patients (61%male). Pi10 was dependent on both GOLD grades 1-4 ( = 0.009) and GOLD groups A-D ( = 0.008); it was particularly elevated in group D, and ROC analysis yielded a cut-off of 0.26 cm. Higher Pi10 was associated to lower FEV % predicted and higher RV/TLC, moreover the annual changes of lung function parameters ( < 0.05), as well as to an airway-dominated phenotype and a history of myocardial infarction ( = 0.001). These associations were confirmed in multivariate analyses. Pi10 was lower in patients receiving triple therapy, in particular in patients of GOLD groups C and D. Pi10 was also a significant predictor for mortality ( = 0.006), even after including multiple other predictors.
In summary, Pi10 was found to be predictive for the course of the disease in COPD, in particular mortality. The fact that Pi10 was lower in patients with severe COPD receiving triple therapy might hint toward additional effects of this functional therapy on airway remodeling.
ClinicalTrials.gov, Identifier: NCT01245933.
胸部计算机断层扫描（CT）越来越多地用于 COPD 患者的表型分析和监测。本研究旨在评估气道壁标准化厚度指标 Pi10 与 COPD 加重、死亡率和三联治疗反应的相关性。
纳入了 COSYCONET 队列中具有前瞻性 CT 扫描的 GOLD 1-4 级患者。使用单变量和多变量比较，自动计算并分析 Pi10 与 COPD 严重程度、合并症、肺功能、呼吸治疗和 6 年期间死亡率之间的关系。
共纳入 433 例患者（61%为男性）。Pi10 依赖于 GOLD 1-4 级（=0.009）和 GOLD A-D 组（=0.008）；在 GOLD 组 D 中尤其升高，ROC 分析得出 0.26cm 的截断值。较高的 Pi10 与较低的 FEV%预测值和较高的 RV/TLC 相关，此外，肺功能参数的年变化（<0.05），以及气道主导表型和心肌梗死病史（=0.001）。这些相关性在多变量分析中得到了证实。接受三联治疗的患者的 Pi10 较低，尤其是 GOLD 组 C 和 D 的患者。Pi10 也是死亡率的显著预测因素（=0.006），即使包括其他多个预测因素。
总之，Pi10 被发现是 COPD 疾病过程的预测指标，特别是死亡率。在接受三联治疗的严重 COPD 患者中，Pi10 较低，这可能提示这种功能治疗对气道重塑有额外的影响。
ClinicalTrials.gov，标识符：NCT01245933。
