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Bronchoarterial ratio in never‐smokers adults: Implications for bronchial dilation definition
Author(s) -
Diaz Alejandro A.,
Young Thomas P.,
Maselli Diego J.,
Martinez Carlos H.,
Maclean Erick S.,
Yen Andrew,
Dass Chandra,
Simpson Scott A.,
Lynch David A.,
Kinney Gregory L.,
Hokanson John E.,
Washko George R.,
San José Estépar Raul
Publication year - 2017
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12875
Subject(s) - medicine , bronchiectasis , bronchus , airway , lung , lumen (anatomy) , cardiology , pulmonary function testing , odds ratio , respiratory disease , surgery
Background and objective Bronchiectasis manifests as recurrent respiratory infections and reduced lung function. Airway dilation, which is measured as the ratio of the diameters of the bronchial lumen (B) and adjacent pulmonary artery (A), is a defining radiological feature of bronchiectasis. A challenge to equating the bronchoarterial ( BA ) ratio to disease severity is that the diameters of airway and vessel in health are not established. We sought to explore the variability of BA ratio in never‐smokers without pulmonary disease and its associations with lung function. Methods Objective measurements of the BA ratio on volumetric computed tomography ( CT ) scans and pulmonary function data were collected in 106 never‐smokers. The BA ratio was measured in the right upper lobe apical bronchus ( RB1 ) and the right lower lobe basal posterior bronchus. The association between the BA ratio and forced expiratory volume in 1 s ( FEV 1 ) was assessed using regression analysis. Results The BA ratio was 0.79 ± 0.16 and was smaller in more peripheral RB1 bronchi ( P < 0.0001). The BA ratio was >1, a typical threshold for bronchiectasis, in 10 (8.5%) subjects. Subjects with a BA ratio >1 versus ≤1 had smaller artery diameters ( P < 0.0001) but not significantly larger bronchial lumens. After adjusting for age, gender, race and height, the BA ratio was directly related to FEV 1 ( P = 0.0007). Conclusion In never‐smokers, the BA ratio varies by airway generation and is associated with lung function. A BA ratio >1 is driven by small arteries. Using artery diameter as reference to define bronchial dilation seems inappropriate.