CT-meting van emfyseem bij zware rokers*

To investigate whether the extent of CT-detected emphysema is associated with accelerated lung function decline and the development of chronic obstructive pulmonary disease (COPD) in heavy smokers and former smokers.

Design

Prospective cohort study.

Method

Heavy smokers and former smokers participating in a lung cancer screening trial underwent CT of the lungs and spirometry at baseline and after a median follow-up of 3 years. The severity of emphysema was assessed on the first CT scan using computer software. The predictive value for lung function after follow-up was the primary outcome. A second analysis was carried out in a subgroup of participants without COPD at baseline to determine the predictive value of emphysema scores for the development of COPD.

Results

2085 heavy smokers with a mean age of 59.8 years and a smoking intensity of 40.3 pack years were included. To a large extent CT-detected emphysema was associated with severe lung function decline and a high risk of developing COPD.

Conclusion

In heavy smokers greater severity of CT-detected emphysema was associated with accelerated lung function decline, even in those without airway obstruction. CT-detection of emphysema can be used to determine whether heavy smokers are at a higher risk of developing COPD.

Conflict of interest: none declared. Financial support: the institution where F. Mohamed Hoesein, P. Zanen and J. Lammers are employed has received a grant from the 7th European Union Framework Programme (grant number 201379 COPACETIC).