Academic Journal
Linking Lungs and Heart: Centrilobular Emphysema and Coronary Artery Calcification Progression Over 18 Years of Follow-Up.
| Τίτλος: | Linking Lungs and Heart: Centrilobular Emphysema and Coronary Artery Calcification Progression Over 18 Years of Follow-Up. |
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| Συγγραφείς: | González J; Biomedical Research Institute of Lleida-Dr. Pifarré Foundation, Institut de Recerca Biomèdica de Lleida, Lleida, Spain; Departament of Pulmonology, Arnau de Vilanova and Santa Maria University Hospital, Lleida, Spain; Centro de Investigación Biomédica en Red Enfermedades Respiratorias, Carlos III Health Institute, Madrid, Spain., Yip R; Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY., Zhang J; Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY., Jirapatnakul A; Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY., Yankelevitz DF; Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY., Henschke CI; Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY; Departments of Medicine, Radiology, and Research, Phoenix Veterans Affairs Health Care System, Phoenix, AZ. Electronic address: claudia.henschke@mountsinai.org. |
| Πηγή: | Chest [Chest] 2026 Aug; Vol. 170 (2), pp. 383-393. Date of Electronic Publication: 2026 Apr 01. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: United States NLM ID: 0231335 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1931-3543 (Electronic) Linking ISSN: 00123692 NLM ISO Abbreviation: Chest Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2016- : New York : Elsevier Original Publication: Chicago : American College of Chest Physicians |
| Ιατρικοί όροι (MeSH): | Coronary Artery Disease*/epidemiology , Coronary Artery Disease*/diagnostic imaging , Vascular Calcification*/diagnostic imaging , Vascular Calcification*/epidemiology , Pulmonary Emphysema*/diagnostic imaging , Pulmonary Emphysema*/epidemiology, Tomography, X-Ray Computed/methods ; Smoking/adverse effects ; Smoking/epidemiology ; Humans ; Disease Progression ; Female ; Middle Aged ; Follow-Up Studies ; Male ; Prospective Studies |
| Περίληψη: | Background: Low-dose CT (LDCT) imaging of the chest for lung cancer screening provides an opportunity to evaluate smoking-related comorbidities such as emphysema and coronary artery calcification (CAC). Although cross-sectional associations exist, the long-term relationship between emphysema subtypes and CAC progression remains undefined. Research Question: Is any emphysema subtype associated with long-term CAC progression? Study Design and Methods: A total of 256 participants with ≥ 15 years of follow-up were included from a prospective cohort of 9,047 asymptomatic, high-risk individuals enrolled in the Mount Sinai Early Lung and Cardiac Action Program (New York, June 2000-August 2004). Emphysema and its 2 subtypes-centrilobular (CLE) emphysema and paraseptal emphysema (PSE)-were assessed visually and graded using an enhanced Fleischner Society classification. CAC was scored using a validated ordinal method. Progression was defined as any increase in total score from baseline to follow-up. Logistic regression was used to identify predictors of CAC progression, including CLE and PSE progression, adjusted for age, smoking status, and pack-years of smoking. Results: Among 256 participants (50% female and 50% male; median age, 58 years [interquartile range (IQR), 52-63]), most participants (69.1%) had a history of former smoking at enrollment, with a median of 31.1 pack-years of smoking (IQR, 21-49 pack-years). Progression of CAC and emphysema was observed in 182 participants (71.7%) and 145 participants (56.6%), respectively, over a median follow-up of 18.3 years (IQR, 16.7-20.5 years). Participants with CAC progression showed significantly higher rates of any emphysema both at baseline (70.9% vs 54.2%; P = .011) and at follow-up (75.8% vs 56.9%; P = .003). This group also showed higher median CLE scores at baseline (2.00 vs 0.00; P < .001) and follow-up (5.00 vs 0.00; P < .001). In multivariable logistic regression adjusted for age, smoking status, and pack-years of smoking, CLE progression was associated strongly with CAC progression (OR, 3.32; 95% CI, 1.75-6.63; P < .001). In contrast, PSE showed no significant association with CAC progression (OR, 1.17; 95% CI, 0.32-5.64; P = .83). Interpretation: Our results show that in this long-term screening cohort, progression of CLE-but not PSE-was linked to CAC progression, highlighting the value of detailed emphysema assessment in screening programs and supporting CLE as a systemic disorder with prognostic relevance. (Copyright © 2026 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.) |
| Competing Interests: | Financial/Nonfinancial Disclosures The authors have reported to CHEST the following: D. F. Y. reports partial support from the Simons Foundation International; royalties or licenses from General Electric; named inventor on a number of patents and patent applications with General Electric related to the evaluation of chest diseases including measurements of chest nodules and has received financial compensation for the licensing of these patents; advisory board participation for and equity ownership in HeartLung; medical advisory board participation for Median Technologies, Carestream, and LungLife AI; and consultant and co-owner of Accumetra. C. I. H. reports partial support from the Simons Foundation International, participation on an advisory board for LungLife AI, named inventor of the patents and pending patents owned by Cornell Research Foundation (since 2009, has divested herself of all royalties and other interests arising from these), and president and board member of Early Diagnosis and Treatment Research Foundation (receives no compensation). None declared (J. G., R. Y., J. Z., A. J.). |
| Contributed Indexing: | Keywords: centrilobular emphysema; coronary artery calcification; emphysema; emphysema subtypes; long-term follow-up; lung cancer screening |
| Entry Date(s): | Date Created: 20260404 Date Completed: 20260810 Latest Revision: 20260823 |
| Update Code: | 20260823 |
| PubMed Central ID: | PMC13494253 |
| DOI: | 10.1016/j.chest.2026.03.022 |
| PMID: | 41933610 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1931-3543 |
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| DOI: | 10.1016/j.chest.2026.03.022 |