Airflow limitation as a risk factor for vascular stiffness

2020 ◽  
Vol 24 (6) ◽  
pp. 577-584
Author(s):  
S. S. Sheen ◽  
H. J. Kim ◽  
D. Singh ◽  
S. C. Hwang ◽  
K. J. Park ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Multivariate Logistic Regression Analysis ◽  
Density Lipoprotein ◽  
Forced Expiratory Volume ◽  
Vascular Stiffness ◽  
University Hospital ◽  
Airflow Limitation ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Health Examination

BACKGROUND: Cardiovascular disease is one of the main causes of mortality in patients with chronic obstructive pulmonary disease (COPD), and atherosclerosis is a cause of cardiac comorbidities in COPD. However, it is not clear whether airflow limitation is associated with atherosclerosis irrespective of smoking.OBJECTIVE: To investigate whether airflow limitation is independently associated with vascular stiffness.METHODS: We enrolled 18 893 participants (male 70.5%; mean age 47.5 ± 9.8 years; never smokers 44.2%) who underwent spirometry and brachial-ankle pulse wave velocity (baPWV) as part of a standard health examination at Ajou University Hospital, Suwon, South Korea, from January 2010 to December 2015.We defined vascular peripheral atherosclerosis as baPWV ≥ 1400 cm/s and airflow limitation as pre-bronchodilator ratio of forced expiratory volume in 1 sec (FEV1) to forced vital capacity (FVC) <70%.RESULTS: Mean baPWV was higher in subjects with airflow limitation (1477.6 ± 331.7 cm/sec, n = 638) than in those without airflow limitation (1344.1 ± 231.8 cm/sec, n = 18255, P < 0.001). In multivariate logistic regression analysis, the following were independent predictors associated with peripheral atherosclerosis (P < 0.05): age, male sex, fasting serum glucose, mean blood pressure, serum leukocyte count, serum low density lipoprotein level and FEV1.CONCLUSION: Airflow limitation was an independent predictor of vascular stiffness irrespective of smoking history, which suggests that airflow limitation is linked with atherosclerosis.

scholarly journals Interaction of Smoking and Lead Exposure among Carriers of Genetic Variants Associated with a Higher Level of Oxidative Stress Indicators

2021 ◽  
Vol 18 (16) ◽  
pp. 8325
Author(s):  
Kuo-Jung Ho ◽  
Tzu-Hua Chen ◽  
Chen-Cheng Yang ◽  
Yao-Chung Chuang ◽  
Hung-Yi Chuang
Keyword(s):  
Oxidative Stress ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Thiobarbituric Acid ◽  
Serum Levels ◽  
Working Environment ◽  
University Hospital ◽  
Health Examination ◽  
Low Density ◽  
Nucleotide Polymorphisms

Smoking and lead (Pb) exposure increased oxidative stress in human body, and people with some gene variants may be susceptible to Pb and smoking via oxidative stress. The aim of this study is to evaluate oxidative stress by measuring thiobarbituric acid reactive substances (TBARS) and the relationship of lipid peroxidation markers in Pb workers with different gene polymorphisms (rs4673 and rs1050450) in both smokers and nonsmokers. Blood samples were collected from 267 Pb workers who received their annual health examination in the Kaohsiung Medical University Hospital. Glutathione peroxidase 1 (GPx-1) rs1050450 and cytochrome B-245 Alpha Chain (CYBA) rs4673 single-nucleotide polymorphisms (SNP) were analyzed by specific primer-probes using Real-Time PCR methods. The interaction between blood Pb and smoking increased serum levels of TBARS and the ratio of oxidative low-density lipoprotein and low-density lipoprotein (oxLDL/LDL). Analysis of workers with rs1050450 SNPs showed higher blood Pb levels in the workers with CC genotype than those with CT genotype. Smokers had significantly higher blood Pb, alanine transaminase (ALT), TBARS, and OxLDL levels than nonsmokers. TBARS increased 0.009 nmol/mL when blood Pb increased one µg/dL in smokers compared to nonsmokers. The ratio of OxLDL/LDL increased 0.223 when blood Pb increased one µg/dL in smokers compared to nonsmokers. TBARS levels and the ratio of OxLDL/LDL were positively correlated and interacted between blood Pb and smoking after the adjustment of confounders, suggesting that smoking cessation is an important issue in the Pb-exposed working environment.

scholarly journals Predictors of COPD in symptomatic smokers and ex-smokers seen in primary care

2018 ◽  
Vol 15 (4) ◽  
pp. 393-399
Author(s):  
Oliver Djurhuus Tupper ◽  
Peter Kjeldgaard ◽  
Anders Løkke ◽  
Charlotte Suppli Ulrik
Keyword(s):  
Primary Care ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Smoking Status ◽  
Multivariate Logistic Regression Analysis ◽  
Forced Expiratory Volume ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Tobacco Exposure ◽  
Tract Infections

Even in subjects at high risk of chronic obstructive pulmonary disease (COPD), the diagnosis is often missed due to lack of awareness of symptoms and risk factors. The objective of this study was to identify predictors of a diagnosis of COPD in symptomatic current and ex-smokers seen in a primary care setting. General practitioners ( n = 241) consecutively recruited subjects ≥ 35 years, with tobacco exposure, at least one respiratory symptom (i.e. cough, sputum, wheeze, dyspnoea and/or recurrent lower respiratory tract infections), and no previous diagnosis of obstructive airways disease. Information on age, smoking status, body mass index (BMI) and dyspnoea (Medical Research Council (MRC) dyspnoea scale) was obtained. Individuals with airway obstruction (i.e. forced expiratory volume in 1 second (FEV1)/forced vital capacity ratio (FVC) < 0.70) at initial spirometry had a diagnostic spirometry after administration of a bronchodilator. COPD was defined as the presence of symptoms, tobacco exposure and persistent airflow limitation. The most prevalent symptoms were cough (72%) and dyspnoea (48%). Of 3875 (50% females, mean age 57 years) subjects screened, 700 (18.1%) were diagnosed with COPD. Multivariate logistic regression analysis revealed that increasing age 50–59 years (OR 2.4, 95% CI 1.8–3.3), 60–69 years (OR 4.1, 95% CI 3.1–5.5), ≥70 years (OR 5.7, 95% CI 4.2–7.8), BMI < 25 (OR 2.3, 95% CI 1.9–2.7), being current smoker (OR 1.2, 95% CI 1.01–1.5), self-reported dyspnoea (OR 1.7, 95% CI 1.4–2.0), wheeze (OR 1.9, 95% CI 1.5–2.3) and sputum (OR 1.4, 95% CI 1.1–1.7) were associated with a significantly higher risk of being diagnosed with COPD. No association was found between gender, cough and recurrent respiratory tract infections and a diagnosis of COPD. Among symptomatic smokers and ex-smokers seen in primary care, self-reported sputum production, wheeze, dyspnoea and low BMI identify a subgroup with a higher likelihood of COPD.

TO ESTIMATE LIPID PROFILE IN PATIENTS WITH COPD

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Roshan Kumar Jha ◽  
Ranjit S. Ambad
Keyword(s):  
Lipid Profile ◽  
Total Cholesterol ◽  
Systemic Disease ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Airflow Limitation ◽  
Respiratory Medicine ◽  
Chronic Obstructive ◽  
Low Density ◽  
Copd Patients

Background: Chronic Obstructive Pulmonary Disease (COPD) includes persistent bronchitis and emphysema, which is generally caused due to smoking of tobacco. (COPD) is an obstructive lung disorder characterized by airflow limitation that is progressive, associated with severe inflammatory response in the air passages and the lungs due to toxic particles. It interferes with normal breathing and is not fully reversible. Objectives: 1. To estimate lipid profile (Total cholesterol (TCH), Triglycerides (TG), High density lipoprotein (HDL), Low density lipoprotein (LDL), Very low-density lipoprotein (VLDL)) in patients with Chronic Obstructive Pulmonary. 2. To find correlation of these parameters with severity of disease. Material and Method: The study was conducted in Department of Biochemistry in collaboration with Department of Respiratory Medicine at Jawaharlal Nehru Medical College and AVBRH, Sawangi (Meghe) Wardha, India. Thirty-two patients diagnosed with COPD were selected from OPD and ward of Respiratory Medicine and thirty-two age and sex matched controls were taken. Result: The analysis of total cholesterol, triglycerides, HDL, LDL, VLDL in cases and controls. Result was statistically significant in between cases and controls of total cholesterol (p<0.001), HDL (p<0.001) and LDL (p<0.001), and statistically not significant in between cases and controls of triglycerides (p=0.6) and VLDL (p=0.98). Conclusion: We conclude that smoking significantly affect lipid profile in COPD patients, as it increases LDL levels and decreases HDL levels. Hence all patients with COPD patients who are smoker’s needs to check their lipid profile. COPD is considered as systemic disease with various co morbidities, which may affect the lipid profile. Keywords: Lipid profile, COPD, AAT, CVD, TNF-α, CRP and GOLD.

scholarly journals The relationship of the serum endocan level with the CHA2DS2-VASc score in patients with paroxysmal atrial fibrillation

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Gökhan Ceyhun
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Stroke Risk ◽  
Low Density Lipoprotein ◽  
Multivariate Logistic Regression Analysis ◽  
Density Lipoprotein ◽  
Roc Curve Analysis ◽  
Reactive Protein ◽  
Relationship Of ◽  
The Relationship

Abstract Background In this study considering the relationship between serum endocan and CHA2DS2-VASc score, we assumed that endocan level could be a new biomarker for stroke risk in patients with paroxysmal atrial fibrillation (PAF). It was examined that endocan could be an alternative to determine the risk of stroke and anticoagulation strategy in patients with PAF. The CHA2DS2-VASc scores were calculated for 192 patients with PAF, and their serum endocan levels were measured. The patients were divided into two groups as those with low to moderate (0-1) and those with high (≥ 2) CHA2DS2-VASc scores, and the endocan levels were compared between these two groups. Results The serum endocan level was significantly higher in the high CHA2DS2-VASc score group (p < 0.001). In the multivariate logistic regression analysis, endocan, C-reactive protein, and low-density lipoprotein were found to be independent determinants of the CHA2DS2-VASc score. The predictive value of endocan was analyzed using the ROC curve analysis, which revealed that endocan predicted a high stroke risk (CHA2DS2-VASc ≥ 2) at 82.5% sensitivity and 71.2% specificity at the cutoff value of 1.342. Conclusion This study indicates that endocan is significantly associated with CHA2DS2-VASc score. We demonstrated that endocan could be a new biomarker for the prediction of a high stroke risk among patients diagnosed with PAF.

Ventilation-perfusion imbalance and chronic obstructive pulmonary disease staging severity

2009 ◽  
Vol 106 (6) ◽  
pp. 1902-1908 ◽  
Author(s):  
Roberto Rodríguez-Roisin ◽  
Mitra Drakulovic ◽  
Diego A. Rodríguez ◽  
Josep Roca ◽  
Joan Albert Barberà ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Gas Exchange ◽  
Pulmonary Disease ◽  
Forced Expiratory Volume ◽  
Pulmonary Gas Exchange ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Gold Stage ◽  
Stage 1

Chronic obstructive pulmonary disease (COPD) is characterized by a decline in forced expiratory volume in 1 s (FEV1) and, in many advanced patients, by arterial hypoxemia with or without hypercapnia. Spirometric and gas exchange abnormalities have not been found to relate closely, but this may reflect a narrow range of severity in patients studied. Therefore, we assessed the relationship between pulmonary gas exchange and airflow limitation in patients with COPD across the severity spectrum. Ventilation-perfusion (V̇A/Q̇) mismatch was measured using the multiple inert gas elimination technique in 150 patients from previous studies. The distribution of patients according to the GOLD stage of COPD was: 15 with stage 1; 40 with stage 2; 32 with stage 3; and 63 with stage 4. In GOLD stage 1, AaPo2 and V̇A/Q̇ mismatch were clearly abnormal; thereafter, hypoxemia, AaPo2, and V̇A/Q̇ imbalance increased, but the changes from GOLD stages 1–4 were modest. Postbronchodilator FEV1 was related to PaO2 ( r = 0.62) and PaCO2 ( r = −0.59) and to overall V̇A/Q̇ heterogeneity ( r = −0.48) ( P < 0.001 each). Pulmonary gas exchange abnormalities in COPD are related to FEV1 across the spectrum of severity. V̇A/Q̇ imbalance, predominantly perfusion heterogeneity, is disproportionately greater than airflow limitation in GOLD stage 1, suggesting that COPD initially involves the smallest airways, parenchyma, and pulmonary vessels with minimal spirometric disturbances. That progression of V̇A/Q̇ inequality with spirometric severity is modest may reflect pathogenic processes that reduce both local ventilation and blood flow in the same regions through airway and alveolar disease and capillary involvement.

Abstract 562: Association Of The Heteroplasmic Level Of The Mitochondrial Gene Nd2 5178c>A Variant With Essential Hypertension

Hypertension ◽  
2014 ◽  
Vol 64 (suppl_1) ◽  
Author(s):  
Tong Yin ◽  
Yusong Zhang ◽  
Xi Chen ◽  
Jie Yang ◽  
Yuxiao Zhang ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Protective Effect ◽  
Total Cholesterol ◽  
Mitochondrial Gene ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Health Examination ◽  
Coding Region ◽  
Chinese Han ◽  
Blood Leukocytes

BACKGROUND: The mitochondrial genetic variant of nicotinamide adenine dinucleotide dehydrogenase subunit-2 (ND2) 5178C>A (Leu237Met) was previously found to have a protective effect against essential hypertension (EH) in Chinese and Japanese populations. AIM: The present study aimed to determine whether the protective effect of ND2 5178C>A against EH is associated with the mitochondrial heteroplasmy level of the variant. METHODS: This case-control study involved 109 unrelated Chinese-Han matched pairs of essential hypertension and healthy normotensive controls. All consented subjects were recruited consecutively from Institute of Geriatric Cardiology and Health Examination Center in General Hospital of Chinese People’s Liberation Army from February 2013 to January 2014. Demographic and clinical characteristics were recorded. Mitochondrial DNA was isolated from the blood leukocytes for each subject. The level of heteroplasmy for 5178C>A variant occurring in the coding region of ND2 was quantified using real-time polymerase chain reaction (PCR) method. RESULTS: The ND2 5178C>A heteroplasmy level ranged between 27% and 77%, with a median level of 44%. Between the upper and lower quartiles of 5178C>A heteroplasmy distribution, significant differences were observed for systolic blood pressure (116±17 vs. 129±25 mmHg, P=0.004) , body mass index (BMI) (24.6±3.3 vs.26.5±3.6, P=0.008) , total cholesterol (4.0±0.8 vs. 3.4±0.9 mmol/L, P<0.001) , low density lipoprotein (2.5±0.7 vs. 1.5±0.7 mmol/L, P<0.001) and triglyceride levels (1.8±1.6 vs. 4.0±1.6 mmol/L, P<0.001). ND2 5178C>A heteroplasmic level was negatively correlated with the presence of hypertension (r = -0.38, P < 0.001), BMI (r = -0.19, P = 0.007), and the level of total cholesterol (r = -0.18, P = 0.01). Logistic regression analysis showed that participants with higher ND2 5178C>A heteroplasmy level (≥44%) were found to have significantly lower prevalence of essential hypertension (29%, 32 in 109), as compared to those with lower (< 44%) ND2 5178C>A heteroplasmy level (71%, 77 in 109) (OR: 0.18, 95% CI: 0.10-0.31, P<0.001). CONCLUSION: The protective effect of mitochondrial ND2 5178C>A against EH is associated with the heteroplasmy level of the variant.

scholarly journals Evaluation of Systemic Renin and Angiotensin II Levels in Normal Tension Glaucoma

2020 ◽  
Vol 9 (12) ◽  
pp. 3838
Author(s):  
Soo Ji Jeon ◽  
Hyung Bin Hwang ◽  
Na Young Lee
Keyword(s):  
Angiotensin Ii ◽  
Complete Blood Count ◽  
Low Density Lipoprotein ◽  
Multivariate Logistic Regression Analysis ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
Normal Tension Glaucoma ◽  
Enzyme Linked Immunosorbent Assay ◽  
Reactive Protein ◽  
Hs Crp

The purpose of this study was to investigate the function of the renin–angiotensin–aldosterone system (RAAS) in normal tension glaucoma (NTG) patients by measuring the level of renin and angiotensin II (AngII) in the plasma. Twenty-four patients with NTG and 38 control subjects were included in this study. Renin and AngII were measured in the blood samples of all subjects by enzyme-linked immunosorbent assay (ELISA). No significant differences were found in the complete blood count, fasting glucose, low-density lipoprotein (LDL), and high-sensitivity C-reactive protein (hs-CRP) levels between the control and NTG groups. The systemic concentration and variability of the renin concentration in the blood was significantly higher in the NTG group (p = 0.005 and 0.005, respectively). According to multivariate logistic regression analysis, the variability of the renin concentration was associated with NTG (p = 0.006). In conclusion, the systemic concentration and variability of renin levels were elevated in NTG patients. An altered renin concentration could represent a difference in RAAS function in NTG patients.

scholarly journals Associations of Measured Smell Function with Adiposity and Cardiometabolic Measures: Results from the 2013–2014 National Health and Nutrition Examination Survey (NHANES) (OR22-02-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Samantha Gallo ◽  
Laura Byham-Gray ◽  
Valerie Duffy ◽  
Howard Hoffman ◽  
John Hayes ◽  
...  
Keyword(s):  
Total Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Smoking History ◽  
Income Poverty ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Nationally Representative ◽  
Self Reported Health Status ◽  
Smell Function

Abstract Objectives To assess the associations between smell function and adiposity and cardiometabolic measures in a nationally representative sample of US adults. Methods In the 2013–2014 NHANES, 3527 adults ≥40 years, completed the NHANES Taste and Smell Exam. Smell function was assessed with an 8-item odor identification test. Participants smelled and identified each odorant by selecting one of four descriptors. Smell impairment was defined as incorrect identification of ≥3 (of 8) odors. Survey-weighted linear regression models estimated cross-sectional associations of smell function with adiposity (body mass index (BMI), waist circumference (WC)) and cardiometabolic measures (total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, fasting plasma glucose (FPG), and systolic (SBP) and diastolic blood pressure (DBP)). Models were adjusted for age, race, education, physical activity, self-reported health status, smoking history, and income-poverty ratio, and stratified by sex and age group (40–64 years vs. ≥65 years). Results In US adults ≥40 years, smell function was significantly associated with several adiposity and cardiometabolic measures in adjusted models, with significant interactions by sex and age. Compared to normal smell, smell impairment was significantly associated with higher BMI [β = 3.0; 95% CI: 0.6, 5.4)] and WC [β = 5.0; 95% CI: 0.3, 9.8] among women <65 years; conversely among men ≥65 years, smell impairment associated with lower BMI [β = −1.6; 95% CI: −3.2, −0.01)]. In adults < 65 years, smell impairment was associated with lower FPG [β = −7.9; 95% CI: −13.0, −2.6] and triglyceride levels [β = −27.0; 95% CI: −51.0, −3.7], but this was only significant among men. In older men (≥65 years), smell impairment was positively associated with higher total cholesterol [β = 12.8; 95% CI: 7.4, 18.1] and LDL [β = 18.1; 95% CI: 9.1, 27.2] ; among older women however, smell impairment was inversely associated with both total [β = −15.0; 95% CI: −25.0, −5.7] and LDL cholesterol [β = −12.0; 95% CI: −25.0, 1.2)], and positively associated with FPG [β = 15.6; 95% CI:1.5, 29.7]. No significant associations were observed with SBP or DBP. Conclusions In adults ≥ 40 years, smell impairment is associated with adiposity measures, and glucose and lipid levels, with differential associations by age and sex. Funding Sources Rutgers University, NJ.

scholarly journals Association of NLRP1 Coding Polymorphism with Lung Function and Serum IL-1β Concentration in Patients Diagnosed with Chronic Obstructive Pulmonary Disease (COPD)

Genes ◽  
2019 ◽  
Vol 10 (10) ◽  
pp. 783 ◽  
Author(s):  
Ozretić ◽  
da Silva Filho ◽  
Catalano ◽  
Sokolović ◽  
Vukić-Dugac ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Minor Allele ◽  
Fine Tuning ◽  
Airflow Limitation ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The Impact

Chronic obstructive pulmonary disease (COPD) is a chronic disease characterized by a progressive decline in lung function due to airflow limitation, mainly related to IL-1β-induced inflammation. We have hypothesized that single nucleotide polymorphisms (SNPs) in NLRP genes, coding for key regulators of IL-1β, are associated with pathogenesis and clinical phenotypes of COPD. We recruited 704 COPD individuals and 1238 healthy controls for this study. Twenty non-synonymous SNPs in 10 different NLRP genes were genotyped. Genetic associations were estimated using logistic regression, adjusting for age, gender, and smoking history. The impact of genotypes on patients’ overall survival was analyzed with the Kaplan–Meier method with the log-rank test. Serum IL-1β concentration was determined by high sensitivity assay and expression analysis was done by RT-PCR. Decreased lung function, measured by a forced expiratory volume in 1 s (FEV1% predicted), was significantly associated with the minor allele genotypes (AT + TT) of NLRP1 rs12150220 (p = 0.0002). The same rs12150220 genotypes exhibited a higher level of serum IL-1β compared to the AA genotype (p = 0.027) in COPD patients. NLRP8 rs306481 minor allele genotypes (AG + AA) were more common in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) definition of group A (p = 0.0083). Polymorphisms in NLRP1 (rs12150220; OR = 0.55, p = 0.03) and NLRP4 (rs12462372; OR = 0.36, p = 0.03) were only nominally associated with COPD risk. In conclusion, coding polymorphisms in NLRP1 rs12150220 show an association with COPD disease severity, indicating that the fine-tuning of the NLRP1 inflammasome could be important in maintaining lung tissue integrity and treating the chronic inflammation of airways.

scholarly journals Predictive Modelling of Lung Function using Emphysematous Density Distribution

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kuo-Lung Lor ◽  
Cheng-Pei Liu ◽  
Yeun-Chung Chang ◽  
Chong-Jen Yu ◽  
Cheng-Yi Wang ◽  
...  
Keyword(s):  
Lung Function ◽  
Predictive Model ◽  
Lung Volume ◽  
Model Fitting ◽  
Chronic Obstructive Lung Disease ◽  
Correlation Study ◽  
Forced Expiratory Volume ◽  
Airflow Limitation ◽  
Normal Lung ◽  
Chronic Obstructive

AbstractTarget lung tissue selection remains a challenging task to perform for treating severe emphysema with lung volume reduction (LVR). In order to target the treatment candidate, the percentage of low attenuation volume (LAV%) representing the proportion of emphysema volume to whole lung volume is measured using computed tomography (CT) images. Although LAV% have shown to have a correlation with lung function in patients with chronic obstructive pulmonary disease (COPD), similar measurements of LAV% in whole lung or lobes may have large variations in lung function due to emphysema heterogeneity. The functional information of regional emphysema destruction is required for supporting the choice of optimal target. The purpose of this study is to develop an emphysema heterogeneity descriptor for the three-dimensional emphysematous bullae according to the size variations of emphysematous density (ED) and their spatial distribution. The second purpose is to derive a predictive model of airflow limitation based on the regional emphysema heterogeneity. Deriving the bullous representation and grouping them into four scales in the upper and lower lobes, a predictive model is computed using the linear model fitting to estimate the severity of lung function. A total of 99 subjects, 87 patients with mild to very severe COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I~IV) and 12 control participants with normal lung functions (forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) > 0.7) were evaluated. The final model was trained with stratified cross-validation on randomly selected 75% of the dataset (n = 76) and tested on the remaining dataset (n = 23). The dispersed cases of LAV% inconsistent with their lung function outcome were evaluated, and the correlation study suggests that comparing to LAV of larger bullae, the widely spread smaller bullae with equivalent LAV has a larger impact on lung function. The testing dataset has the correlation of r = −0.76 (p < 0.01) between the whole lung LAV% and FEV1/FVC, whereas using two ED % of scales and location-dependent variables to predict the emphysema-associated FEV1/FVC, the results shows their correlation of 0.82 (p < 0.001) with clinical FEV1/FVC.

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