{"doi":"10.17615/esdr-g636","title":"Vessel and Airway Characteristics in One-Year Computed Tomography-defined Rapid Emphysema Progression: SPIROMICS.","abstract":"<strong>Rationale:</strong> Rates of emphysema progression vary in chronic obstructive pulmonary disease (COPD), and the relationships with vascular and airway pathophysiology remain unclear. <strong>Objectives:</strong> We sought to determine if indices of peripheral (segmental and beyond) pulmonary arterial dilation measured on computed tomography (CT) are associated with a 1-year index of emphysema (EI; percentage of voxels &lt;-950 Hounsfield units) progression. <strong>Methods:</strong> Five hundred ninety-nine former and never-smokers (Global Initiative for Chronic Obstructive Lung Disease stages 0-3) were evaluated from the SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study) cohort: rapid emphysema progressors (RPs; <em>n</em>&thinsp;=&thinsp;188, 1-year &Delta;EI&thinsp;&gt;&thinsp;1%), nonprogressors (<em>n</em>&thinsp;=&thinsp;301, 1-year &Delta;EI&thinsp;&plusmn;&thinsp;0.5%), and never-smokers (<em>n</em>&thinsp;=&thinsp;110). Segmental pulmonary arterial cross-sectional areas were standardized to associated airway luminal areas (segmental pulmonary artery-to-airway ratio [PAAR<sub>seg</sub>]). Full-inspiratory CT scan-derived total (arteries and veins) pulmonary vascular volume (TPVV) was compared with small vessel volume (radius smaller than 0.75&thinsp;mm). Ratios of airway to lung volume (an index of dysanapsis and COPD risk) were compared with ratios of TPVV to lung volume. <strong>Results:</strong> Compared with nonprogressors, RPs exhibited significantly larger PAAR<sub>seg</sub> (0.73&thinsp;&plusmn;&thinsp;0.29 vs. 0.67&thinsp;&plusmn;&thinsp;0.23; <em>P</em>&thinsp;=&thinsp;0.001), lower ratios of TPVV to lung volume (3.21&thinsp;&plusmn;&thinsp;0.42% vs. 3.48&thinsp;&plusmn;&thinsp;0.38%; <em>P</em>&thinsp;=&thinsp;5.0&thinsp;&times;&thinsp;10<sup>-12</sup>), lower ratios of airway to lung volume (0.031&thinsp;&plusmn;&thinsp;0.003 vs. 0.034&thinsp;&plusmn;&thinsp;0.004; <em>P</em>&thinsp;=&thinsp;6.1&thinsp;&times;&thinsp;10<sup>-13</sup>), and larger ratios of small vessel volume to TPVV (37.91&thinsp;&plusmn;&thinsp;4.26% vs. 35.53&thinsp;&plusmn;&thinsp;4.89%; <em>P</em>&thinsp;=&thinsp;1.9&thinsp;&times;&thinsp;10<sup>-7</sup>). In adjusted analyses, an increment of 1 standard deviation in PAAR<sub>seg</sub> was associated with a 98.4% higher rate of severe exacerbations (95% confidence interval, 29-206%; <em>P</em>&thinsp;=&thinsp;0.002) and 79.3% higher odds of being in the RP group (95% confidence interval, 24-157%; <em>P</em>&thinsp;=&thinsp;0.001). At 2-year follow-up, the CT-defined RP group demonstrated a significant decline in postbronchodilator percentage predicted forced expiratory volume in 1&thinsp;second. <strong>Conclusions:</strong> Rapid one-year progression of emphysema was associated with indices indicative of higher peripheral pulmonary vascular resistance and a possible role played by pulmonary vascular-airway dysanapsis.","journal":"UNC Libraries","year":2025,"id":581117,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9573,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":175299,"name":"Stephen Rennard","orcid":null,"position":1,"is_corresponding":false},{"id":250088,"name":"MeiLan K. Han","orcid":"0000-0002-9095-4419","position":2,"is_corresponding":false},{"id":435947,"name":"Sarah E. Gerard","orcid":"0000-0001-8101-3150","position":3,"is_corresponding":false},{"id":777391,"name":"Amin Motahari","orcid":"0000-0001-6314-3867","position":4,"is_corresponding":false},{"id":71913,"name":"Richard E. Kanner","orcid":"0000-0001-6915-599X","position":5,"is_corresponding":false},{"id":250087,"name":"Nadia N. Hansel","orcid":"0000-0002-8740-9751","position":6,"is_corresponding":false},{"id":250090,"name":"Eric A. Hoffman","orcid":"0000-0001-8456-9437","position":7,"is_corresponding":false},{"id":250097,"name":"Prescott G. Woodruff","orcid":"0000-0003-3176-0603","position":8,"is_corresponding":false},{"id":350033,"name":"John D. Newell","orcid":"0000-0002-7337-5001","position":9,"is_corresponding":false},{"id":250083,"name":"David Couper","orcid":"0000-0002-4313-9235","position":10,"is_corresponding":false},{"id":24685,"name":"R. Graham Barr","orcid":"0000-0001-8021-0072","position":11,"is_corresponding":false},{"id":250081,"name":"Alejandro P. Comellas","orcid":"0000-0003-1521-7520","position":12,"is_corresponding":false},{"id":1492815,"name":"SPIROMICS Research Group","orcid":null,"position":13,"is_corresponding":false},{"id":355320,"name":"Spyridon Fortis","orcid":"0000-0001-7807-6740","position":14,"is_corresponding":false},{"id":326544,"name":"Punam K. Saha","orcid":"0000-0003-1576-118X","position":15,"is_corresponding":false},{"id":354166,"name":"Prashant Nagpal","orcid":"0000-0003-2347-034X","position":16,"is_corresponding":false},{"id":33125,"name":"Fernando J. Martínez","orcid":"0000-0002-2412-3182","position":17,"is_corresponding":false},{"id":1492816,"name":"Ella A. Kazeroni","orcid":null,"position":18,"is_corresponding":false},{"id":1492817,"name":"Timothy M. Dougherty","orcid":null,"position":19,"is_corresponding":false},{"id":250096,"name":"Joyce Schroeder","orcid":"0000-0002-7451-4886","position":20,"is_corresponding":false},{"id":250094,"name":"Robert Paine","orcid":"0000-0002-4511-4437","position":21,"is_corresponding":false},{"id":250082,"name":"Christopher B. Cooper","orcid":"0000-0002-6314-0903","position":22,"is_corresponding":false},{"id":655508,"name":"Junfeng Guo","orcid":"0000-0002-9397-647X","position":23,"is_corresponding":false},{"id":326331,"name":"Benjamin M. Smith","orcid":"0000-0002-0619-5799","position":24,"is_corresponding":false},{"id":678953,"name":"Dakai Jin","orcid":"0000-0002-4806-2943","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:58:47.357782Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}