The COPD assessment test correlates well with the computed tomography measurements in COPD patients in China

Abstract

Yan Zhang,* You-Hui Tu,* Guang-He FeiPulmonary Department, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China*These authors contributed equally to this workBackground: The chronic obstructive pulmonary disease (COPD) assessment test (CAT) is a validated simple instrument to assess health status, and it correlates well with the severity of airway obstruction in COPD patients. However, little is known about the relationships between CAT scores and quantitative computed tomography (CT) measurements of emphysema and airway wall thickness in COPD patients in the People’s Republic of China. Methods: One hundred and twelve participants including 63 COPD patients and 49 normal control subjects were recruited. All participants were examined with high-resolution CT to get the measurements of emphysema (percentage of pixels below -950 HU [%LAA–950]) and airway wall thickness (wall area percentage and the ratio of airway wall thickness to total diameter). Meanwhile, they completed the CAT and modified Medical Research Council questionnaire independently.Results: Significantly higher CAT scores and CT measurements were found in COPD patients compared with normal control subjects (P<0.05), and there was a tendency of higher CAT scores and CT measurements with increasing disease severity measured by GOLD staging system. Positive correlations were found between CAT scores and CT measurements (P<0.01). Using multiple linear stepwise regression, CAT score =-46.38+0.778× (wall area percentage) +0.203× (%LAA–950) (P<0.001). Meanwhile, CAT scores and CT measurements in COPD patients all positively correlated with the modified Medical Research Council grades and negatively correlated with FEV1% (P<0.01). Conclusion: CAT scores correlate well with the quantitative CT measurements in COPD patients, which may provide an imaging evidence that the structural changes of the lungs in this disease are associated with the health status measured by CAT. Keywords: chronic obstructive pulmonary disease, pulmonary function, quantitative computed tomography