• Firdaus A A Mohamed Hoesein, Michael Schmidt, Onno M Mets, Hester A Gietema, Jan-Willem J Lammers, Pieter Zanen, Harry J de Koning, Carlijn van der Aalst, Matthijs Oudkerk, Rozemarijn Vliegenthart, Ivana Isgum, Mathias Prokop, Bram van Ginneken, Eva M van Rikxoort, and Pim A de Jong.
• Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: fmohamedhoesein@gmail.com.
• Respir Med. 2014 Jan 1;108(1):136-43.

BackgroundFinding phenotypes within COPD patients may prove imperative for optimizing treatment and prognosis. We hypothesized that it would be possible to discriminate emphysematous, large airway wall thickening and small airways disease dominant phenotypes.MethodsInspiratory and expiratory CTs were performed in 1140 male smokers without or with mild COPD to quantify emphysema, airway wall thickness and air trapping. Spirometry, residual volume to total lung capacity (RV/TLC) and diffusion capacity (Kco) were measured. Dominant phenotype (emphysema, airway wall thickening or air trapping dominant) was defined as one of the respective CT measure in the upper quartile, with the other measures not in the upper quartile.Results573 subjects had any of the three CT measures in the upper quartile. Of these, 367 (64%) were in a single dominant group and 206 (36%) were in a mixed group. Airway wall thickening dominance was associated with younger age (p < 0.001), higher body mass index (p < 0.001), more wheezing (p < 0.05) and lower FEV1 %predicted (p < 0.001). Emphysema dominant subjects had lower FEV1/FVC (p < 0.05) and Kco %predicted (p < 0.05). There was no significant difference in respiratory related hospitalizations (p = 0.09).ConclusionCT measures can discriminate three different CT dominant groups of disease in male smokers without or with mild COPD.Trial Registration NumberISRCTN63545820, registered at www.trialregister.nl.Copyright © 2013 Elsevier Ltd. All rights reserved.

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