1
|
Ezponda A, Casanova C, Divo M, Marín-Oto M, Cabrera C, Marín JM, Bastarrika G, Pinto-Plata V, Martin-Palmero Á, Polverino F, Celli BR, de Torres JP. Chest CT-assessed comorbidities and all-cause mortality risk in COPD patients in the BODE cohort. Respirology 2022; 27:286-293. [PMID: 35132732 PMCID: PMC9303420 DOI: 10.1111/resp.14223] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/11/2022] [Accepted: 01/19/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVE The availability of chest computed tomography (CT) imaging can help diagnose comorbidities associated with chronic obstructive pulmonary disease (COPD). Their systematic identification and relationship with all-cause mortality have not been explored. Furthermore, whether their CT-detected prevalence differs from clinical diagnosis is unknown. METHODS The prevalence of 10 CT-assessed comorbidities was retrospectively determined at baseline in 379 patients (71% men) with mild to severe COPD attending pulmonary clinics. Anthropometrics, smoking history, dyspnoea, lung function, exercise capacity, BODE (BMI, Obstruction, Dyspnoea and Exercise capacity) index and exacerbations rate were recorded. The prevalence of CT-determined comorbidities was compared with that recorded clinically. Over a median of 78 months of observation, the independent association with all-cause mortality was analysed. A 'CT-comorbidome' graphically expressed the strength of their association with mortality risk. RESULTS Coronary artery calcification, emphysema and bronchiectasis were the most prevalent comorbidities (79.8%, 62.7% and 33.9%, respectively). All were underdiagnosed before CT. Coronary artery calcium (hazard ratio [HR] 2.09; 95% CI 1.03-4.26, p = 0.042), bronchiectasis (HR 2.12; 95% CI 1.05-4.26, p = 0.036) and low psoas muscle density (HR 2.61; 95% CI 1.23-5.57, p = 0.010) were independently associated with all-cause mortality and helped define the 'CT-comorbidome'. CONCLUSION This study of COPD patients shows that systematic detection of 10 CT-diagnosed comorbidities, most of which were not detected clinically, provides information of potential use to patients and clinicians caring for them.
Collapse
Affiliation(s)
- Ana Ezponda
- Radiology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Ciro Casanova
- Pulmonary Department, Hospital Ntra Sra de Candelaria, Tenerife, Spain.,Respiratory Research Unit, Hospital Ntra Sra de Candelaria, Tenerife, Spain
| | - Miguel Divo
- Pulmonary Department, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Marta Marín-Oto
- Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Carlos Cabrera
- Pulmonary Department, Hospital Universitario Doctor Negrín, Las Palmas, Spain
| | - Jose M Marín
- Pulmonary Department, Hospital Universitario Miguel Servet, Instituto Aragonés Ciencias Salud & CIBERES, Zaragoza, Spain
| | - Gorka Bastarrika
- Radiology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Víctor Pinto-Plata
- Pulmonary Department, Baystate Medical Center, Springfield, Massachusetts, USA
| | | | - Francesca Polverino
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona, USA
| | - Bartolome R Celli
- Pulmonary Department, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Juan P de Torres
- Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain.,Respiratory Investigation Unit, Queen's University, Kingston, Ontario, Canada.,Respirology and Sleep Medicine Division, Queen's University, Kingston, Ontario, Canada
| |
Collapse
|
2
|
Fortunato G, Vidal DTA, Klein W, Neto A, Angrizani A, Vasconcelos JF, Kaneto C, Souza BSDF, Ribeiro-dos-Santos R, Soares MBP, Macambira SG. Recovery of pulmonary structure and exercise capacity by treatment with granulocyte-colony stimulating factor (G-CSF) in a mouse model of emphysema. Pulm Pharmacol Ther 2013; 27:144-9. [PMID: 23603459 DOI: 10.1016/j.pupt.2013.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Revised: 04/01/2013] [Accepted: 04/02/2013] [Indexed: 01/08/2023]
Abstract
Emphysema is a chronic obstructive pulmonary disease characterized abnormal dilatation of alveolar spaces, which impairs alveolar gas exchange, compromising the physical capacity of a patient due to airflow limitations. Here we tested the effects of G-CSF administration in pulmonary tissue and exercise capacity in emphysematous mice. C57Bl/6 female mice were treated with elastase intratracheally to induce emphysema. Their exercise capacities were evaluated in a treadmill. Lung histological sections were prepared to evaluate mean linear intercept measurement. Emphysematous mice were treated with G-CSF (3 cycles of 200 μg/kg/day for 5 consecutive days, with 7-day intervals) or saline and submitted to a third evaluation 8 weeks after treatment. Values of run distance and linear intercept measurement were expressed as mean ± SD and compared applying a paired t-test. Effects of treatment on these parameters were analyzed applying a Repeated Measures ANOVA, followed by Tukey's post hoc analysis. p < 0.05 was considered statistically significant. Twenty eight days later, animals ran significantly less in a treadmill compared to normal mice (549.7 ± 181.2 m and 821.7 ± 131.3 m, respectively; p < 0.01). Treatment with G-CSF significantly increased the exercise capacity of emphysematous mice (719.6 ± 200.5 m), whereas saline treatment had no effect on distance run (595.8 ± 178.5 m). The PCR cytokines genes analysis did not detect difference between experimental groups. Morphometric analyses in the lung showed that saline-treated mice had a mean linear intercept significantly higher (p < 0.01) when compared to mice treated with G-CSF, which did not significantly differ from that of normal mice. Treatment with G-CSF promoted the recovery of exercise capacity and regeneration of alveolar structural alterations in emphysematous mice.
Collapse
Affiliation(s)
- Gustavo Fortunato
- Programa de Pós-Graduação em Biotecnologia, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brazil.
| | - Daniel T A Vidal
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brazil; Centro de Biotecnologia e Terapia Celular, Hospital São Rafael, Salvador, BA, Brazil.
| | - Wilfried Klein
- Departamento de Biologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, SP, Brazil; Instituto Nacional de Ciência e Tecnologia em Fisiologia Comparada, UNESP, Rio Claro, SP, Brazil.
| | - Alberto Neto
- Programa de Pós-Graduação em Biotecnologia, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brazil; Centro de Biotecnologia e Terapia Celular, Hospital São Rafael, Salvador, BA, Brazil.
| | - André Angrizani
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brazil.
| | - Juliana F Vasconcelos
- Programa de Pós-Graduação em Biotecnologia, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brazil; Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brazil.
| | - Carla Kaneto
- Centro de Biotecnologia e Terapia Celular, Hospital São Rafael, Salvador, BA, Brazil.
| | | | | | - Milena B P Soares
- Programa de Pós-Graduação em Biotecnologia, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brazil; Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brazil; Centro de Biotecnologia e Terapia Celular, Hospital São Rafael, Salvador, BA, Brazil.
| | - Simone G Macambira
- Programa de Pós-Graduação em Biotecnologia, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brazil; Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brazil; Centro de Biotecnologia e Terapia Celular, Hospital São Rafael, Salvador, BA, Brazil; Departamento de Biofunção, Instituto de Ciências da Saúde, Universidade Federal da Bahia, BA, Brazil.
| |
Collapse
|