ArticleAnnals of the American Thoracic Society2014
Variation in the percent of emphysema-like lung in a healthy, nonsmoking multiethnic sample. The MESA lung study.
Article in Annals of the American Thoracic Society, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 92 papers, 1 of them a synthesis that pooled it.
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Who cites it
92 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Use of Computed Tomography Densitometry for the Assessment of Emphysema in Clinical Trials: A Position Paper from the Fleischner Society.American journal of respiratory and critical care medicine · 2025Pooled it
- Significant Spirometric Transitions and Preserved Ratio Impaired Spirometry Among Ever Smokers.Chest · 2022Trial
- Reproducibility of airway luminal size in asthma measured by HRCT.Journal of applied physiology (Bethesda, Md. : 1985) · 2017Trial
- Emphysema Severity Index: a new spirometric parameter in epidemiology.ERJ open research · 2026Article
- Precise Lung Density Quantification with a Physics-based CT Harmonizer.Radiology. Cardiothoracic imaging · 2026Observational
- Mapping the trajectory from pre-COPD to COPD: predictive value of symptoms, imaging, and physiologic abnormalities.Annals of the American Thoracic Society · 2026Article
- Mucus plugs in chronic obstructive pulmonary disease are heterogeneous in size and shape and occur in relatively large airways.American journal of respiratory and critical care medicine · 2026Article
- Hair follicle gene expression profiling in the SubPopulations and InteRmediate Outcome Measures in COPD Study (SPIROMICS).BMC medical genomics · 2025Article
- Frequency and characteristics of emphysema in adults with FLNA variants: a single-center study.Orphanet journal of rare diseases · 2025Observational
- Genetic resilience to chronic obstructive pulmonary disease is a clinically distinct subtype in individuals with cigarette smoke exposure.Respiratory research · 2025Article
- Uncertainty-aware quantitative CT evaluation of emphysema and mortality risk from variable radiation dose images.European radiology · 2025Article
- Post-COPD: Can Emphysema Be Repaired?American journal of respiratory and critical care medicine · 2025Article
- Mechanically Affected Lung and Progression of Emphysema.American journal of respiratory and critical care medicine · 2025Article
- Proteomic discovery analysis of quantitatively assessed emphysema in the general population. The MESA Lung Study.Respiratory research · 2025Article
- Associations of Prepandemic Lung Function and Structure with COVID-19 Outcomes: The C4R Study.American journal of respiratory and critical care medicine · 2025Article
- Article
- Sex Differences in Chronic Obstructive Pulmonary Disease: Implications for Pathogenesis, Diagnosis, and Treatment.International journal of molecular sciences · 2025Review
- Sex differences in asthma control, lung function and exacerbations: the ATLANTIS study.BMJ open respiratory research · 2024Observational
- Structural Predictors of Lung Function Decline in Young Smokers with Normal Spirometry.American journal of respiratory and critical care medicine · 2024Article
- ROBUST QUANTIFICATION OF PERCENT EMPHYSEMA ON CT VIA DOMAIN ATTENTION: THE MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA) LUNG STUDY.Proceedings. IEEE International Symposium on Biomedical Imaging · 2024Article
32 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
rationaleComputed tomography (CT)-based lung density is used to quantitate the percentage of emphysema-like lung (hereafter referred to as percent emphysema), but information on its distribution among healthy nonsmokers is limited.
objectivesWe evaluated percent emphysema and total lung volume on CT scans of healthy never-smokers in a multiethnic, population-based study.
methodsThe Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study investigators acquired full-lung CT scans of 3,137 participants (ages 54-93 yr) between 2010-12. The CT scans were taken at full inspiration following the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) protocol. "Healthy never-smokers" were defined as participants without a history of tobacco smoking or respiratory symptoms and disease. "Percent emphysema" was defined as the percentage of lung voxels below -950 Hounsfield units. "Total lung volume" was defined by the volume of lung voxels. MEASUREMENTS AND MAIN
resultsAmong 854 healthy never-smokers, the median percent emphysema visualized on full-lung scans was 1.1% (interquartile range, 0.5-2.5%). The percent emphysema values were 1.2 percentage points higher among men compared with women and 0.7, 1.2, and 1.2 percentage points lower among African Americans, Hispanics, and Asians compared with whites, respectively (P < 0.001). Percent emphysema was positively related to age and height and inversely related to body mass index. The findings were similar for total lung volume on CT scans and for percent emphysema defined at -910 Hounsfield units and measured on cardiac scans. Reference equations to account for these differences are presented for never, former and current smokers.
conclusionsSimilar to lung function, percent emphysema varies substantially by demographic factors and body size among healthy never-smokers. The presented reference equations will assist in defining abnormal values for percent emphysema and total lung volume on CT scans, although validation is pending.
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