Higher Frequency of Typical Usual Interstitial Pneumonia Radiologic Pattern in COPD

This article is part of Pulmonology Advisor‘s coverage of the CHEST 2019 meeting, taking place in New Orleans, LA. Our staff will report on medical research related to asthma, COPD, critical care medicine, and more conducted by experts in the field. Check back regularly for more news from CHEST 2019.

NEW ORLEANS — A typical interstitial pneumonia pattern was the predominant radiologic pattern seen in patients with chronic obstructive pulmonary disease (COPD) and pulmonary hypertension (PH), according to research presented at the CHEST Annual Meeting held October 19 to 23, in New Orleans, Louisiana.

Researchers conducted a retrospective study to examine patterns in high-resolution chest computed tomography imaging in patients with and without COPD. They categorized the patterns as typical, probable, indeterminate, and consistent with nonidiopathic pulmonary fibrosis. The cohort of 63 patients included 11 cases of typical interstitial pneumonia and 52 atypical cases. The mean patient age was 67±9.9 years; 57% had a positive smoking history and 56% were men.

Compared with individuals without COPD, a typical pattern of interstitial pneumonia was observed more frequently among patients with COPD (47.37% vs 4.55%; P =.001). In addition, patients with PH had a greater prevalence of typical interstitial pneumonia patterns than those without PH (62.5% vs 10.9%; P =.002). The distribution of typical and atypical interstitial pneumonia patterns did not differ significantly by comorbidities such as obesity, smoking, heart failure, obstructive sleep apnea, or connective tissue disorders.

The researchers noted that although there was not a higher prevalence of typical patterns of interstitial pneumonia among participants who were current and past smokers, patients who developed COPD as a result of smoking may be susceptible to developing a typical interstitial pneumonia pattern through similar mechanisms of inflammation.

“A higher frequency of typical [interstitial pneumonia] pattern in patients with COPD supports earlier studies describing [combined pulmonary fibrosis and emphysema], and may represent a pathophysiologic connection between processes that underlie both emphysema and pulmonary fibrosis,” the researchers wrote.

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Reference

Bhatt A, Lam J, Li X, Condos R, Ko J, Gibson C. An analysis of usual interstitial pneumonia patterns in patients with COPD. Presented at: CHEST Annual Meeting 2019; October 19-23, 2019; New Orleans, LA. Abstract 971.