3D-CT-derived lung volumes and mortality risk in patients with fibrotic hypersensitivity pneumonitis.

IF 6.2 2区 医学 Q1 ALLERGY
Shusuke Yazawa, Yuzo Suzuki, Yuko Tanaka, Koshi Yokomura, Masato Kono, Dai Hashimoto, Atsuki Fukada, Yusuke Inoue, Hideki Yasui, Hironao Hozumi, Masato Karayama, Kazuki Furuhashi, Noriyuki Enomoto, Tomoyuki Fujisawa, Naoki Inui, Takafumi Suda
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引用次数: 0

Abstract

Background: Hypersensitivity pneumonitis (HP) is a complex and heterogenous interstitial lung disease (ILD) that occurs in susceptible individuals due to certain inhaled antigens. Fibrotic-HP is a major underlying disease of progressive pulmonary fibrosis. Therefore, in addition to the radiological features of HP, quantitatively measuring fibrosis is important to evaluate disease severity and progression. The present study aimed to compare three-dimensional computed tomography (3D-CT)-derived lung volumes (LVs) of patients with HP and determine its association with mortality risk.

Methods: In this retrospective and multicenter cohort study, 126 patients diagnosed with HP (fibrotic, n = 72 and non-fibrotic, n = 54) with a confidence level higher than moderate were enrolled. Each lobe LV was measured using 3D-CT at the time of diagnosis and standardized using predicted forced vital capacity. The 3D-CT LV was compared with those of 42 controls and 140 patients with idiopathic pulmonary fibrosis (IPF).

Results: Compared to patients with fibrotic-HP, the standardized total LV was significantly higher in controls and patients with non-fibrotic-HP and was similar in patients with IPF. Longitudinal analyses demonstrated that approximately half of the patients with fibrotic-HP had an annual decrease in total LV. Decreased total and lower-lobe LVs were associated with shorter survival, and were independently associated with mortality together with ongoing exposure to inciting antigens. A composite model consisting of ongoing exposure to inciting antigens and total or lower-lobe LV successfully classified mortality risk into three groups.

Conclusions: Quantitatively measuring standardized LV can help determine disease severity, progression, and mortality risk in patients with fibrotic-HP.

纤维化超敏性肺炎患者的三维 CT 导出肺容积和死亡风险。
背景:超敏性肺炎(HP)是一种复杂的异质性间质性肺病(ILD),易感者因吸入某些抗原而发病。纤维化性肺炎是进行性肺纤维化的主要基础疾病。因此,除了 HP 的放射学特征外,纤维化的定量测量对于评估疾病的严重程度和进展也很重要。本研究旨在比较三维计算机断层扫描(3D-CT)得出的HP患者肺容积(LV),并确定其与死亡风险的关系:在这项回顾性多中心队列研究中,共纳入了126名确诊为HP(纤维化,72人;非纤维化,54人)且置信度高于中度的患者。在诊断时使用 3D-CT 测量了每个肺叶的左心室,并使用预测的用力肺活量进行了标准化。将 3D-CT 左心室与 42 例对照组和 140 例特发性肺纤维化(IPF)患者的左心室进行比较:结果:与纤维化-HP 患者相比,对照组和非纤维化-HP 患者的标准化总左心室明显更高,而 IPF 患者的总左心室与之相似。纵向分析表明,约半数纤维化-高血压患者的总左心室容量每年都在下降。总左心室和下叶左心室缩小与生存期缩短有关,并且与持续暴露于诱发抗原的死亡率独立相关。由持续暴露于诱发抗原和总左心室或下叶左心室组成的复合模型成功地将死亡风险分为三组:定量测量标准化左心室有助于确定纤维化肝病患者的疾病严重程度、进展和死亡风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Allergology International
Allergology International ALLERGY-IMMUNOLOGY
CiteScore
12.60
自引率
5.90%
发文量
96
审稿时长
29 weeks
期刊介绍: Allergology International is the official journal of the Japanese Society of Allergology and publishes original papers dealing with the etiology, diagnosis and treatment of allergic and related diseases. Papers may include the study of methods of controlling allergic reactions, human and animal models of hypersensitivity and other aspects of basic and applied clinical allergy in its broadest sense. The Journal aims to encourage the international exchange of results and encourages authors from all countries to submit papers in the following three categories: Original Articles, Review Articles, and Letters to the Editor.
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