Computed tomography measure of lung injury and future interstitial features: The cardia lung study

Gabrielle Y. Liu; Laura A. Colangelo; Samuel Y. Ash; Raul San Jose Estepar; David R. Jacobs; Bharat Thyagarajan; J. Michael Wells; Rachel K. Putman; Bina Choi; Christopher S. Stevenson; Mercedes Carnethon; George R. Washko; Ravi Kalhan

doi:10.1183/23120541.00004-2023

Computed tomography measure of lung injury and future interstitial features: The cardia lung study

Gabrielle Y. Liu^*, Laura A. Colangelo, Samuel Y. Ash, Raul San Jose Estepar, David R. Jacobs, Bharat Thyagarajan, J. Michael Wells, Rachel K. Putman, Bina Choi, Christopher S. Stevenson, Mercedes Carnethon, George R. Washko, Ravi Kalhan

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Introduction Visually normal areas of the lung with high attenuation on computed tomography (CT) imaging, termed CT lung injury, may represent injured but not yet remodelled lung parenchyma. This prospective cohort study examined if CT lung injury is associated with future interstitial features on CT and restrictive spirometry abnormality among participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Methods CARDIA is a population-based cohort study. CT scans obtained at two time points were assessed objectively for amount of lung tissue characterised as CT lung injury and interstitial features. Restrictive spirometry was defined as having a forced vital capacity (FVC) <80% predicted with forced expiratory volume in 1 s/FVC ratio >70%. Results Among 2213 participants, the median percentage of lung tissue characterised as CT lung injury at a mean age of 40 years was 3.4% (interquartile range 0.8–18.0%). After adjustment for covariates, a 10% higher amount of CT lung injury at mean age 40 years was associated with a 4.37% (95% CI 3.99–4.74%) higher amount of lung tissue characterised as interstitial features at mean age 50 years. Compared to those with the lowest quartile of CT lung injury at mean age 40 years, there were higher odds of incident restrictive spirometry at mean age 55 years in quartile 2 (OR 2.05, 95% CI 1.20–3.48), quartile 3 (OR 2.80, 95% CI 1.66–4.72) and quartile 4 (OR 3.77, 95% CI 2.24–6.33). Conclusions CT lung injury is an early objective measure that indicates risk of future lung impairment.

Original language	English (US)
Article number	00004-2023
Journal	ERJ Open Research
Volume	9
Issue number	3
DOIs	https://doi.org/10.1183/23120541.00004-2023
State	Published - May 1 2023

Funding

Support statement: G.Y. Liu was supported by National Institutes of Health (NIH) grant F32-HL162318. S.Y. Ash was supported by NIH K08HL145118. R. Kalhan was supported in part by National Heart, Lung, and Blood Institute (NHLBI) grant R01 HL122477(Coronary Artery Risk Development in Young Adults Study (CARDIA) Lung Study). CARDIA was conducted and supported by the NHLBI in collaboration with the University of Alabama at Birmingham (HHSN268201800005I and HHSN268201800007I), Northwestern University (HHSN268201800003I), the University of Minnesota (HHSN268201800006I) and the Kaiser Foundation Research Institute (HHSN268201800004I). Additional funding was received from NHLBI R01 HL122477 (CARDIA Lung Study) and F32 HL162318 (G.Y. Liu). This work was partially funded by Janssen Research & Development, LLC. This manuscript has been reviewed by CARDIA for scientific content. Funding information for this article has been deposited with the Crossref Funder Registry.

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine

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10.1183/23120541.00004-2023

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Liu, G. Y., Colangelo, L. A., Ash, S. Y., Estepar, R. S. J., Jacobs, D. R., Thyagarajan, B., Wells, J. M., Putman, R. K., Choi, B., Stevenson, C. S., Carnethon, M., Washko, G. R., & Kalhan, R. (2023). Computed tomography measure of lung injury and future interstitial features: The cardia lung study. ERJ Open Research, 9(3), Article 00004-2023. https://doi.org/10.1183/23120541.00004-2023

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title = "Computed tomography measure of lung injury and future interstitial features: The cardia lung study",

abstract = "Introduction Visually normal areas of the lung with high attenuation on computed tomography (CT) imaging, termed CT lung injury, may represent injured but not yet remodelled lung parenchyma. This prospective cohort study examined if CT lung injury is associated with future interstitial features on CT and restrictive spirometry abnormality among participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Methods CARDIA is a population-based cohort study. CT scans obtained at two time points were assessed objectively for amount of lung tissue characterised as CT lung injury and interstitial features. Restrictive spirometry was defined as having a forced vital capacity (FVC) <80% predicted with forced expiratory volume in 1 s/FVC ratio >70%. Results Among 2213 participants, the median percentage of lung tissue characterised as CT lung injury at a mean age of 40 years was 3.4% (interquartile range 0.8–18.0%). After adjustment for covariates, a 10% higher amount of CT lung injury at mean age 40 years was associated with a 4.37% (95% CI 3.99–4.74%) higher amount of lung tissue characterised as interstitial features at mean age 50 years. Compared to those with the lowest quartile of CT lung injury at mean age 40 years, there were higher odds of incident restrictive spirometry at mean age 55 years in quartile 2 (OR 2.05, 95% CI 1.20–3.48), quartile 3 (OR 2.80, 95% CI 1.66–4.72) and quartile 4 (OR 3.77, 95% CI 2.24–6.33). Conclusions CT lung injury is an early objective measure that indicates risk of future lung impairment.",

author = "Liu, {Gabrielle Y.} and Colangelo, {Laura A.} and Ash, {Samuel Y.} and Estepar, {Raul San Jose} and Jacobs, {David R.} and Bharat Thyagarajan and Wells, {J. Michael} and Putman, {Rachel K.} and Bina Choi and Stevenson, {Christopher S.} and Mercedes Carnethon and Washko, {George R.} and Ravi Kalhan",

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doi = "10.1183/23120541.00004-2023",

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T1 - Computed tomography measure of lung injury and future interstitial features

T2 - The cardia lung study

AU - Liu, Gabrielle Y.

AU - Colangelo, Laura A.

AU - Ash, Samuel Y.

AU - Estepar, Raul San Jose

AU - Jacobs, David R.

AU - Thyagarajan, Bharat

AU - Wells, J. Michael

AU - Putman, Rachel K.

AU - Choi, Bina

AU - Stevenson, Christopher S.

AU - Carnethon, Mercedes

AU - Washko, George R.

AU - Kalhan, Ravi

PY - 2023/5/1

Y1 - 2023/5/1

N2 - Introduction Visually normal areas of the lung with high attenuation on computed tomography (CT) imaging, termed CT lung injury, may represent injured but not yet remodelled lung parenchyma. This prospective cohort study examined if CT lung injury is associated with future interstitial features on CT and restrictive spirometry abnormality among participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Methods CARDIA is a population-based cohort study. CT scans obtained at two time points were assessed objectively for amount of lung tissue characterised as CT lung injury and interstitial features. Restrictive spirometry was defined as having a forced vital capacity (FVC) <80% predicted with forced expiratory volume in 1 s/FVC ratio >70%. Results Among 2213 participants, the median percentage of lung tissue characterised as CT lung injury at a mean age of 40 years was 3.4% (interquartile range 0.8–18.0%). After adjustment for covariates, a 10% higher amount of CT lung injury at mean age 40 years was associated with a 4.37% (95% CI 3.99–4.74%) higher amount of lung tissue characterised as interstitial features at mean age 50 years. Compared to those with the lowest quartile of CT lung injury at mean age 40 years, there were higher odds of incident restrictive spirometry at mean age 55 years in quartile 2 (OR 2.05, 95% CI 1.20–3.48), quartile 3 (OR 2.80, 95% CI 1.66–4.72) and quartile 4 (OR 3.77, 95% CI 2.24–6.33). Conclusions CT lung injury is an early objective measure that indicates risk of future lung impairment.

AB - Introduction Visually normal areas of the lung with high attenuation on computed tomography (CT) imaging, termed CT lung injury, may represent injured but not yet remodelled lung parenchyma. This prospective cohort study examined if CT lung injury is associated with future interstitial features on CT and restrictive spirometry abnormality among participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Methods CARDIA is a population-based cohort study. CT scans obtained at two time points were assessed objectively for amount of lung tissue characterised as CT lung injury and interstitial features. Restrictive spirometry was defined as having a forced vital capacity (FVC) <80% predicted with forced expiratory volume in 1 s/FVC ratio >70%. Results Among 2213 participants, the median percentage of lung tissue characterised as CT lung injury at a mean age of 40 years was 3.4% (interquartile range 0.8–18.0%). After adjustment for covariates, a 10% higher amount of CT lung injury at mean age 40 years was associated with a 4.37% (95% CI 3.99–4.74%) higher amount of lung tissue characterised as interstitial features at mean age 50 years. Compared to those with the lowest quartile of CT lung injury at mean age 40 years, there were higher odds of incident restrictive spirometry at mean age 55 years in quartile 2 (OR 2.05, 95% CI 1.20–3.48), quartile 3 (OR 2.80, 95% CI 1.66–4.72) and quartile 4 (OR 3.77, 95% CI 2.24–6.33). Conclusions CT lung injury is an early objective measure that indicates risk of future lung impairment.

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Computed tomography measure of lung injury and future interstitial features: The cardia lung study

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