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Association between Cardiorespiratory Fitness and Bronchiectasis at CT: A Long-term Population-based Study of Healthy Young Adults Aged 18-30 Years in the CARDIA Study.

Authors
  • Diaz, Alejandro A1
  • Colangelo, Laura A1
  • Okajima, Yuka1
  • Yen, Andrew1
  • Sala, Marc A1
  • Dransfield, Mark T1
  • Tino, Gregory1
  • Ross, James C1
  • San José Estépar, Raúl1
  • Washko, George R1
  • Kalhan, Ravi1
  • 1 From the Division of Pulmonary and Critical Care Medicine (A.A.D., Y.O., G.R.W.) and Department of Radiology (J.C.R., R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.A.C., R.K.); Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.A.S., R.K.); Department of Radiology, University of California, San Diego, San Diego, Calif (A.Y.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama School of Medicine, Birmingham, Ala (M.T.D.); and Department of Medicine, Penn Presbyterian Medical Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (G.T.).
Type
Published Article
Journal
Radiology
Publisher
Radiological Society of North America
Publication Date
Jul 01, 2021
Volume
300
Issue
1
Pages
190–196
Identifiers
DOI: 10.1148/radiol.2021203874
PMID: 33904771
Source
Medline
Language
English
License
Unknown

Abstract

Background Protective factors against the risk of bronchiectasis are unknown. A high level of cardiorespiratory fitness is associated with a lower risk of chronic obstructive pulmonary disease. But whether fitness relates to bronchiectasis remains, to the knowledge of the authors, unknown. Purpose To examine the association between cardiorespiratory fitness and bronchiectasis. Materials and Methods This was a secondary analysis of a prospective observational study: the Coronary Artery Risk Development in Young Adults cohort (from 1985-1986 [year 0] to 2015-2016 [year 30]). During a 30-year period, healthy participants (age at enrollment 18-30 years) underwent treadmill exercise testing at year 0 and year 20 visits. Cardiorespiratory fitness was determined according to the treadmill exercise duration. The 20-year difference in cardiorespiratory fitness was used as the fitness measurement. At year 25, chest CT was performed to assess bronchiectasis and was used as the primary outcome. Multivariable logistic models were performed to determine the association between cardiorespiratory fitness changes and bronchiectasis. Results Of 2177 selected participants (at year 0: mean age, 25 years ± 4 [standard deviation]; 1224 women), 209 (9.6%) had bronchiectasis at year 25. After adjusting for age, race-sex group, study site, body mass index, pack-years smoked, history of tuberculosis, pneumonia, asthma and myocardial infarction, peak lung function, and cardiorespiratory fitness at baseline, preservation of cardiorespiratory fitness was associated with lower odds of bronchiectasis at CT at year 25 (per 1-minute-longer treadmill duration from year 0 to year 20: odds ratio [OR], 0.88; 95% CI: 0.80, 0.98; P = .02). A consistent strong association was found when cough and phlegm were included in bronchiectasis (OR, 0.72; 95% CI: 0.59, 0.87; P < .001). Conclusion In a long-term follow-up, the preservation of cardiorespiratory fitness was associated with lower odds of bronchiectasis at CT. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Stojanovska in this issue.

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