Lung diffusing capacity relates better to short-term progression on HRCT abnormalities than spirometry in mild asbestosis

Authors

  • Cristiano Rabelo Nogueira MD, PhD,

    1. Respiratory Division - Federal University of São Paulo (UNIFESP) - São Paulo, SP, Brazil
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  • Lara Maris Nápolis PT, PhD,

    1. Respiratory Division - Federal University of São Paulo (UNIFESP) - São Paulo, SP, Brazil
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  • Ericson Bagatin MD, PhD,

    1. Occupational Health Area, State University of Campinas (UNICAMP), Campinas, SP, Brazil
    2. Medical School of Jundiaí, Jundiaí, SP, Brazil
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    • Assistant Professor of Occupational Health Area; Assistant Professor of Medical School of Jundiaí.

  • Mario Terra-Filho MD, PhD,

    1. Pulmonary Division, InCor-HC, University of Sao Paulo Medical School, São Paulo, SP, Brazil
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    • Associate Professor of Pulmonary Division.

  • Nestor L. Müller MD, PhD,

    1. Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada
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    • Head of the Department of Radiology.

  • C. Isabela S. Silva MD, PhD,

    1. Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada
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    • Research Associate - Department of Radiology.

  • Reynaldo Tavares Rodrigues MD, MSc,

    1. Department of Radiology, Federal University of Sao Paulo (UNIFESP), São Paulo, SP, Brazil
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    • Assistant Professor of Radiology.

  • J. Alberto Neder MD, PhD,

    1. Respiratory Division - Federal University of São Paulo (UNIFESP) - São Paulo, SP, Brazil
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    • Head of the Respiratory Division.

  • Luiz E. Nery MD, PhD

    Corresponding author
    1. Respiratory Division - Federal University of São Paulo (UNIFESP) - São Paulo, SP, Brazil
    • Division of Respiratory Diseases, Department of Medicine, Federal University of São Paulo (UNIFESP), Rua Botucatu 740, 3° andar, Vila Clementino, CEP:04023-062 São Paulo, SP, Brazil.
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    • Head of the Respiratory Division.

    • Associate Professor of Respiratory Division.

Errata

This article is corrected by:

  1. Errata: Erratum to “Lung diffusing capacity relates better to short-term progression on HRCT abnormalities than spirometry in mild asbestosis” Volume 54, Issue 7, 569–570, Article first published online: 2 May 2011

Abstract

Background

Pulmonary function tests (PFT), particularly spirometry and lung diffusing capacity for carbon monoxide (DLCO), have been considered useful methods for the detection of the progression of interstitial asbestos abnormalities as indicated by high-resolution computed tomography (HRCT). However, it is currently unknown which of these two tests correlates best with anatomical changes over time.

Methods

In this study, we contrasted longitudinal changes (3–9 years follow-up) in PFTs at rest and during exercise with interstitial abnormalities evaluated by HRCT in 63 ex-workers with mild-to-moderate asbestosis.

Results

At baseline, patients presented with low-grade asbestosis (Huuskonen classes I–II), and most PFT results were within the limits of normality. In the follow-up, most subjects had normal spirometry, static lung volumes and arterial blood gases. In contrast, frequency of DLCO abnormalities almost doubled (P < 0.05). Twenty-three (36.5%) subjects increased the interstitial marks on HRCT. These had significantly larger declines in DLCO compared to patients who remained stable (0.88 vs. 0.31 ml/min/mm Hg/year and 3.5 vs. 1.2%/year, respectively; P < 0.05). In contrast, no between-group differences were found for the other functional tests, including spirometry (P > 0.05).

Conclusions

These data demonstrate that the functional consequences of progression of HRCT abnormalities in mild-to-moderate asbestosis are better reflected by decrements in DLCO than by spirometric changes. These results might have important practical implications for medico-legal evaluation of this patient population. Am. J. Ind. Med. 54:185–193, 2011. © 2010 Wiley-Liss, Inc.

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