Development and Progression of Interstitial Lung Abnormalities in the Framingham Heart Study.
The relationship between the development and/or progression of interstitial lung abnormalities (ILA) and clinical outcomes has not been previously investigated.



To determine the risk factors for, and the clinical consequences of, having ILA progression in participants from the Framingham Heart Study.



ILA were assessed in 1,867 participants who had serial chest computed tomography (CT) scans approximately 6 years apart. Mixed effect regression (and Cox) models were used to assess the association between ILA progression and pulmonary function decline (and mortality).



During the follow-up period 660 (35%) participants did not have ILA on either CT scan, 37 (2%) had stable to improving ILA, and 118 (6%) had ILA with progression (the remaining participants without ILA were noted to be indeterminate on at least one CT scan). Increasing age and increasing copies of the MUC5B promoter polymorphism were associated with ILA progression. After adjustment for covariates, ILA progression was associated with a greater FVC decline when compared with participants without ILA (20 ml; SE, ±6 ml; P = 0.0005) and with those with ILA without progression (25 ml; SE, ±11 ml; P = 0.03). Over a median follow-up time of approximately 4 years, after adjustment, ILA progression was associated with an increase in the risk of death (hazard ratio, 3.9; 95% confidence interval, 1.3-10.9; P = 0.01) when compared with those without ILA.



These findings demonstrate that ILA progression in the Framingham Heart Study is associated with an increased rate of pulmonary function decline and increased risk of death.
1 Center for Pulmonary Functional Imaging.|2 Department of Radiology.
Tetsuro
T
Araki
3 Pulmonary and Critical Care Division.
Rachel K
RK
Putman
1 Center for Pulmonary Functional Imaging.|2 Department of Radiology.
Hiroto
H
Hatabu
4 The NHLBI's Framingham Heart Study, Boston, Massachusetts.|5 Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts.
Wei
W
Gao
4 The NHLBI's Framingham Heart Study, Boston, Massachusetts.|5 Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts.
Josée
J
Dupuis
6 Department of Medicine and.|7 Department of Neurology, Boston University, Boston, Massachusetts.
Jeanne C
JC
Latourelle
2 Department of Radiology.|8 Surgical Planning Laboratory, Department of Radiology, and.
Mizuki
M
Nishino
3 Pulmonary and Critical Care Division.
Oscar E
OE
Zazueta
8 Surgical Planning Laboratory, Department of Radiology, and.
Sila
S
Kurugol
8 Surgical Planning Laboratory, Department of Radiology, and.|9 Channing Laboratory, Brigham and Women's Hospital, Boston, Massachusetts.
James C
JC
Ross
2 Department of Radiology.|8 Surgical Planning Laboratory, Department of Radiology, and.
Raúl
R
San José Estépar
10 Pulmonary Center, Department of Medicine, University of Colorado, Denver, Colorado; and.
David A
DA
Schwartz
3 Pulmonary and Critical Care Division.
Ivan O
IO
Rosas
3 Pulmonary and Critical Care Division.
George R
GR
Washko
4 The NHLBI's Framingham Heart Study, Boston, Massachusetts.|11 Pulmonary Center, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
George T
GT
O'Connor
1 Center for Pulmonary Functional Imaging.|3 Pulmonary and Critical Care Division.
Gary M
GM
Hunninghake
D000367:Age Factors; D000368:Aged; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D016016:Proportional Hazards Models; D012129:Respiratory Function Tests / Q000706:statistics & numerical data; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
MUC5B; idiopathic pulmonary fibrosis; interstitial lung abnormalities; interstitial lung disease; progression