Relationship between the airway wall area and asthma control score in moderate persistent asthma |
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Authors: | Pierre-Yves Brillet Philippe A. Grenier Catalin I. Fetita Catherine Beigelman-Aubry Yahya Ould-Hmeidi Margarete Ortner Gaëlle Nachbaur Lukasz Adamek Pascal Chanez |
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Affiliation: | 1. Université Paris 13, Sorbonne Paris Cité, UPRES EA 2363, Service de radiologie, Assistance Publique – H?pitaux de Paris, H?pital Avicenne, Bobigny, France 2. Université Pierre et Marie Curie, INSERM U678, Service de radiologie, Assistance Publique–H?pitaux de Paris, H?pital Pitié-Salpêtrière, Paris, France 3. ARTEMIS Department, CNRS UMR 8145, Telecom SudParis/Institut Mines-Telecom, Evry, France 4. Operational Medical Excellence Department, GlaxoSmithKline, France 5. Respiratory Centre of Excellence, GlaxoSmithKline, Uxbridge, UK 6. Département des Maladies Respiratoires, AP-HM, Laboratoire d’immunologie INSERM CNRS U 1067, UMR7733, Aix Marseille Université, Marseille, France
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Abstract: | Objectives To assess the association between airway wall area and clinical asthma control, assessed by the Asthma Control Test (ACT). Methods This cross-sectional study evaluated 96 adults for asthma control [“at least well controlled” (ACT ≥ 20; n = 52) or “not well controlled” (ACT < 20; n = 44) and airway dimensions: luminal area (LA), wall area (WA) and WA%], obtained using automated dedicated software measurements from volumetric CT images. Results were analysed for segmental bronchi, subsegmental bronchi in the right upper lobe and basilar segments, both uncorrected and corrected for body surface area (BSA). Results For all bronchi corrected for BSA, there was no correlation between airway wall area and ACT score. There was a weak but statistically significant correlation between uncorrected WA and ACT score (r = -0.203; P = 0.047); WA values were numerically higher in the “not well-controlled” versus the “at least well-controlled asthma” subgroups. For sub-segmental bronchi, there was a correlation between the ACT score and both WA/BSA (r = -0.204; P = 0.047) and WA (r = -0.249; P = 0.014), and for upper lobe bronchi, between the ACT score and WA (r = -0.207; P = 0.044). Conclusion We demonstrated a correlation between subsegmental bronchial airway measurements and clinical control of asthma; this is probably a reflection of airway remodelling and structural changes in chronic poorly controlled asthma. Key Points ? Volumetric computed tomography offers new insights into bronchial morphology. ? The relationship between current asthma control and airway wall abnormalities is assessed. ? Some relationships between airway wall area and clinical control were demonstrated. ? We observed less shape variation of bronchi in “not well-controlled” asthma patients. |
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