Association between Cardiorespiratory Fitness and Bronchiectasis at CT: A Long-term Population-based Study of Healthy Young Adults Aged 18–30 Years in the CARDIA Study

Alejandro A. Diaz*, Laura A. Colangelo, Yuka Okajima, Andrew Yen, Marc A. Sala, Mark T. Dransfield, Gregory Tino, James C. Ross, Raúl San José Estépar, George R. Washko, Ravi Kalhan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: Protective factors against the risk of bronchiectasis are unknown. A high level of cardiorespiratory fitness is associated with a lower risk of chronic obstructive pulmonary disease. But whether fitness relates to bronchiectasis remains, to the knowledge of the authors, unknown. Purpose: To examine the association between cardiorespiratory fitness and bronchiectasis. Materials and Methods: This was a secondary analysis of a prospective observational study: the Coronary Artery Risk Development in Young Adults cohort (from 1985–1986 [year 0] to 2015–2016 [year 30]). During a 30-year period, healthy participants (age at enrollment 18–30 years) underwent treadmill exercise testing at year 0 and year 20 visits. Cardiorespiratory fitness was determined according to the treadmill exercise duration. The 20-year difference in cardiorespiratory fitness was used as the fitness measurement. At year 25, chest CT was performed to assess bronchiectasis and was used as the primary outcome. Multivariable logistic models were performed to determine the association between cardiorespiratory fitness changes and bronchiectasis. Results: Of 2177 selected participants (at year 0: mean age, 25 years 6 4 [standard deviation]; 1224 women), 209 (9.6%) had bronchiectasis at year 25. After adjusting for age, race-sex group, study site, body mass index, pack-years smoked, history of tuberculosis, pneumonia, asthma and myocardial infarction, peak lung function, and cardiorespiratory fitness at baseline, preservation of cardiorespiratory fitness was associated with lower odds of bronchiectasis at CT at year 25 (per 1-minute–longer treadmill duration from year 0 to year 20: odds ratio [OR], 0.88; 95% CI: 0.80, 0.98; P = .02). A consistent strong association was found when cough and phlegm were included in bronchiectasis (OR, 0.72; 95% CI: 0.59, 0.87; P , .001). Conclusion: In a long-term follow-up, the preservation of cardiorespiratory fitness was associated with lower odds of bronchiectasis at CT.

Original languageEnglish (US)
Pages (from-to)190-196
Number of pages7
JournalRadiology
Volume300
Issue number1
DOIs
StatePublished - Jul 2021

Funding

A.A.D. supported by the National Heart, Lung, and Blood Institute (grants R01-HL133137, R01-HL149861) and the Brigham and Women’s Hospital Minority Faculty Career Development Award. J.C.R. supported by the National Institutes of Health. Study supported by the National Heart, Lung, and Blood Institute in collaboration with the University of Alabama at Birmingham (HHSN268201800005I, HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I). Additional funding was provided by National Heart, Lung, and Blood Institute (grant R01-HL122477) (CARDIA Lung Study). This manuscript has been reviewed by CARDIA for scientific content. The National Heart, Lung, and Blood Institute had input into the overall design and conduct of our study and was represented on the publications committee that approved this article.

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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