Association of bronchial disease on CT imaging and clinical definitions of chronic bronchitis in a single-center COPD phenotyping study

Marisa Fat; Tyler Andersen; Jane C Fazio; Seon Cheol Park; Fereidoun Abtin; Russell G Buhr; Jonathan E Phillips; John Belperio; Donald P Tashkin; Christopher B Cooper; Igor Barjaktarevic

doi:10.1016/j.rmed.2024.107733

Association of bronchial disease on CT imaging and clinical definitions of chronic bronchitis in a single-center COPD phenotyping study

Respir Med. 2024 Sep:231:107733. doi: 10.1016/j.rmed.2024.107733. Epub 2024 Jul 8.

Authors

Affiliations

¹ Graduate Education, University of California, Los Angeles (UCLA), Los Angeles, CA, USA; Anne Burnett Marion School of Medicine at TCU, Fort Worth, TX, USA.
² Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
³ Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
⁴ Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
⁵ Department of Radiology, UCLA, Los Angeles, CA, USA.
⁶ Inflammation Discovery Research, Amgen, Thousand Oaks, CA, USA.
⁷ Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Exercise Physiology Research Laboratory, Department of Physiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
⁸ Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. Electronic address: IBarjaktarevic@mednet.ucla.edu.

PMID: 38986793
DOI: 10.1016/j.rmed.2024.107733

Abstract

Introduction: Chronic Bronchitis (CB) represents a phenotype of chronic obstructive pulmonary disease (COPD). While several definitions have been used for diagnosis, the relationship between clinical definitions and radiologic assessment of bronchial disease (BD) has not been well studied. The aim of this study was to evaluate the relationship between three clinical definitions of CB and radiographic findings of BD in spirometry-defined COPD patients.

Methods: A cross-sectional analysis was performed from a COPD phenotyping study. It was a prospective observational cohort. Participants had spirometry-defined COPD and available chest CT imaging. Comparison between CB definitions, Medical Research Council (CB_MRC), St. George's Respiratory Questionnaire (CB_SGRQ), COPD Assessment Test (CB_CAT) and CT findings were performed using Cohen's Kappa, univariate and multivariate logistic regressions.

Results: Of 112 participants, 83 met inclusion criteria. Demographics included age of 70.1 ± 7.0 years old, predominantly male (59.0 %), 45.8 ± 30.8 pack-year history, 21.7 % actively smoking, and mean FEV₁ 61.5 ± 21.1 %. With MRC, SGRQ and CAT definitions, 22.9 %, 36.6 % and 28.0 % had CB, respectively. BD was more often present in CB compared to non-CB patients; however, it did not have a statistically significant relationship between any of the CB definitions. CB_SGRQ had better agreement with radiographically assessed BD compared to the other two definitions.

Conclusion: Identification of BD on CT was associated with the diagnoses of CB. However, agreement between imaging and definitions were not significant, suggesting radiologic findings of BD and criteria defining CB may not identify the same COPD phenotype. Research to standardize imaging and clinical methods is needed for more objective identification of COPD phenotypes.

Keywords: Bronchial disease; COPD; Chronic bronchitis; Visual read.

Publication types

Observational Study

MeSH terms

Aged
Bronchitis, Chronic* / diagnostic imaging
Bronchitis, Chronic* / physiopathology
Cross-Sectional Studies
Female
Forced Expiratory Volume / physiology
Humans
Male
Middle Aged
Phenotype*
Prospective Studies
Pulmonary Disease, Chronic Obstructive* / diagnostic imaging
Pulmonary Disease, Chronic Obstructive* / physiopathology
Spirometry*
Surveys and Questionnaires
Tomography, X-Ray Computed* / methods