Relationship between the airway wall area and asthma control score in moderate persistent asthma
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To assess the association between airway wall area and clinical asthma control, assessed by the Asthma Control Test (ACT).
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).
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).
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.
• 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.
KeywordsMultidetector row computed tomography Quantitative evaluation Asthma control Asthma Control Test Adults
This study was funded by GlaxoSmithKline (study no. 111750). The authors would like to thank the investigators who recruited and cared for patients in this study. Thanks are also extended to Marc Poterre for his input into the original concept and design of the study and to Kate Hollingworth for editorial support in the form of developing a draft outline and first draft, assembling tables and figures, and collating author comments (funded by GlaxoSmithKline)
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