Allergy and Airway: Asthma and Allergy |

Application Research on Asthma Phenotype Using Low Dose CT Scan and Quantitative Analysis FREE TO VIEW

Zhengdao Lai; Tingting Xia; Xiaoxian Zhang; Jiaxing Xie; Yubao Guan; Qingling Zhang
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State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A4. doi:10.1016/j.chest.2016.02.006
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SESSION TITLE: Asthma and Allergy

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, April 17, 2016 at 02:15 PM - 03:45 PM

PURPOSE: Using low dose CT scan and quantitative analysis to evaluate airway remodeling and air trapping in asthmatic patients, discuss and define CT phenotype of asthma.

METHODS: 52 stable asthmatic patients, included 29 cases of severe asthma, 23 cases of non-severe asthma, and 20 cases of healthy control subjects were studied, with completed clinical data, paired inspiratory and respiratory phase CT scan and quantitative analysis of CT images. The factor and cluster analysis of quantitative CT index were used to analyze CT phenotypes of asthmatic patients, and their clinical features were studied by differences in statistics analysis of the clinical index of the 3 different CT phenotypes.

RESULTS: Lumen area (LA and LA/BSA) and Total area (TA and TA/BSA) of severe asthmatics were less than the healthy control subjects (P<0.05). The wall area or volume percentage (WA%/WV%) of severe asthma were more than healthy control subjects (P=0.007). Both severe and non-severe asthmatic patients had higher air trapping and Expiratory VI-850 (%) than that in healthy control subjects (31.6%vs.14.0%, P<0.05), and air trapping of severe asthmatic patients were greater than non-severe asthma. There was a correlation between the airway structure and function in asthmatic patients (P<0.05). CT phenotypes of asthma reflected the state of airway remodeling and air trapping in asthmatic patients. Cluster 1 (n=11) demonstrates increased LA and WA but without air trapping. On the contrary, cluster 3 (n=8) subjects have no obvious airway remolding but the most severe air trapping. Cluster 2 (n=29) indicated decreased LA and increased WA% with mild-to-moderate air trapping.

CONCLUSIONS: Severe asthma has greater air remolding and air trapping in comparison with mild-to-moderate asthma. There was a correlation between the structure and function of airway in asthmatic patients. Quantitative CT analysis provides a new perspective in asthma phenotyping, which might prove useful in patient selection for novel therapies.

CLINICAL IMPLICATIONS: According to the difference situation of airway remolding and air trapping, asthmatics is classified to three various CT phennotype. It approves a theoretical foundation of novel individualized treatment in asthma

DISCLOSURE: The following authors have nothing to disclose: Zhengdao Lai, Tingting Xia, Xiaoxian Zhang, Jiaxing Xie, Yubao Guan, Qingling Zhang

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