ArticleRespiratory research2020
Validation of a method to assess emphysema severity by spirometry in the COPDGene study.
Article in Respiratory research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 12 citations in OpenAlex.
- Clinical Trial of Losartan for Pulmonary Emphysema: Pulmonary Trials Cooperative Losartan Effects on Emphysema Progression Clinical Trial.American journal of respiratory and critical care medicine · 2022Trial
- Emphysema Severity Index: a new spirometric parameter in epidemiology.ERJ open research · 2026Article
- Maternal smoking and CC-16: implications for lung development and COPD across the lifespan.American journal of respiratory and critical care medicine · 2026Article
- Correlation between CT-determined emphysema and the severity of acute exacerbation of chronic obstructive pulmonary disease: a cross-sectional study.Frontiers in medicine · 2026Article
- Post-COPD: Can Emphysema Be Repaired?American journal of respiratory and critical care medicine · 2025Article
- What is worth measuring in patients with COPD?Multidisciplinary respiratory medicine · 2025Article
- Standard spirometry to assess emphysema in patients with chronic obstructive pulmonary disease: the Emphysema Severity Index (ESI).Multidisciplinary respiratory medicine · 2021Article
- Clinical and Radiological Features of COPD Patients Living at ≥3000 m Above Sea Level in the Tibet Plateau.International journal of chronic obstructive pulmonary disease · 2021Observational
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundStandard spirometry cannot identify the predominant mechanism underlying airflow obstruction in COPD, namely emphysema or airway disease. We aimed at validating a previously developed methodology to detect emphysema by mathematical analysis of the maximal expiratory flow-volume (MEFV) curve in standard spirometry.
methodsFrom the COPDGene population we selected those 5930 subjects with MEFV curve and inspiratory-expiratory CT obtained on the same day. The MEFV curve descending limb was fit real-time using forced vital capacity (FVC), peak expiratory flow, and forced expiratory flows at 25, 50 and 75% of FVC to derive an emphysema severity index (ESI), expressed as a continuous positive numeric parameter ranging from 0 to 10. According to inspiratory CT percent lung attenuation area below - 950 HU we defined three emphysema severity subgroups (%LAA
resultsESI differentiated CT emphysema severity subgroups increasing in parallel with GOLD stages (p < .001), but with high variability within each stage. ESI had significantly higher correlations (p < .001) with emphysema than with airway disease CT metrics, explaining 67% of %pLDA variability. Conversely, standard spirometric variables (FEV
conclusionsESI adds to standard spirometry the power to discriminate whether emphysema is the predominant mechanism of airway obstruction. ESI methodology has been validated in the large multiethnic population of smokers of the COPDGene study and therefore it could be applied for clinical and research purposes in the general population of smokers, using a readily available online website.
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