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Original Research |

Measuring Airway Remodeling in Patients with Different COPD Staging Using Endobronchial Optical Coherence Tomography

Ming Ding, M.D; Yu Chen, Ph.D; Wei-jie Guan, Ph.D; Chang-hao Zhong, M.D; Mei Jiang, M.D; Wei-zhan Luo, M.D; Xiao-bo Chen, M.D; Chun-li Tang, M.D; Yan Tang, M.D; Qi-ming Jian, M.D; Wei Wang, M.D; Shi-yue Li, M.D; Nan-shan Zhong, M.D.
Author and Funding Information

M. D. and W. G. drafted the manuscript; M. D., Y. C., C. Z., W. L. and X.C. were responsible for patient recruitment; Y. C., X. C., C. T., Y. T., Q. J., and W. W. collected individual data; M. D., W. G. and M. J. performed statistical analyses; M. D., Y. C., W. G., S. L. and N. Z. contributed to study conception; S. L. and N. Z. provided critical review of the manuscript and approved the final submission.

Primary source of funding: This study was supported by the Special Funds for Public Welfare Research and Capacity Building in Guangdong Province (No.: 2014A020215036) and Research projects of National Health and Family Planning commission of China, 2014 (No.: 201402024).

Conflict of interest: Profs. Li declared that he had received the Special funds for public welfare research and capacity building in Guangdong Province (No.:2014A020215036) and the Research projects of National Health and Family Planning commission of China, 2014 (No.: 201402024). All other authors declared no potential conflict of interest. None of the funding sources had any role on the study.

1State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China

2Department of Cardiology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China

Corresponding author 1: Nan-shan Zhong, M. D., State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Address: 151 Yanjiang Road, Guangzhou, Guangdong, China,

∗∗Corresponding author 2: Shi-yue Li, M.D, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Address: 151 Yanjiang Road, Guangzhou, Guangdong, China,


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Chest. 2016. doi:10.1016/j.chest.2016.07.033
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Abstract

Background  Although forced expiratory volume in one second (FEV1) remains the gold standard for staging COPD, the association between airway remodeling and airflow limitation remains unclear.

Objective  Endobronchial optical coherence tomography (EB-OCT) was performed to assess the association between disorders of large- and medium-to-small-sized airways and COPD staging. We also evaluated small-airway architecture in heavy-smokers with normal FEV1 (SNL) and healthy never-smokers.

Methods  We recruited 48 COPD patients (stage Ⅰ, n=14; stage Ⅱ, n=15; stage Ⅲ-Ⅳ, n=19), 21 SNL, and 17 healthy never-smokers. Smoking history inquiry, spirometry, chest computed tomography, bronchoscopy and EB-OCT were performed. Mean luminal diameter (Dmean), inner luminal area (Ai), and airway wall area (Aw) of generation 3∼9 bronchi were measured using EB-OCT.

Results  Patients with more advanced COPD demonstrated greater abnormality of airway architecture in both large- and medium-to-small-sized airways, followed by SNL and never-smokers. Abnormality of airway architecture and EB-OCT parameters in SNL were comparable to those with stage I COPD. FEV1% predicted correlated with D and Ai of generation 7∼9 in COPD; however, neither D nor Ai of generation 3∼6 correlated with FEV1% in stage Ⅰ and Ⅱ COPD and SNL.

Conclusions  FEV1-based COPD staging partially correlates with small-airway disorders in stage Ⅱ-Ⅳ COPD. EB-OCT-detected small airway abnormalities correlate with FEV1-based staging in COPD and identify early pathology in healthy heavy-smokers.


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