April 28, 2021
2 min read
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Diaz and Stojanovska do not report any relevant financial information. In the study you will find all relevant financial information from all other authors.
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Maintaining cardiorespiratory fitness over 2 decades was associated with a lower likelihood of developing bronchiectasis on CT scans after 25 years, researchers in radiology reported.
“Studies have shown that higher levels of cardiorespiratory fitness are associated with a reduced risk of decreased lung function and incidence of respiratory diseases such as chronic obstructive pulmonary disease,” said Dr. Alejandro A. Diaz, MPH, professor of medicine at Harvard Medical School and fellow scientists in the Department of Pulmonary and Intensive Care Medicine at Brigham and Women’s Hospital and colleagues wrote. “To our knowledge, however, it is not known whether cardiorespiratory fitness reduces the risk of bronchiectasis.”
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Researchers performed a secondary analysis of the evolution of coronary artery risk in young adults (CARDIA), a prospective long-term observational study in healthy individuals aged 18 to 30 years. The current analysis focused on 2,177 participants (mean age 25 years; 56.2% women). Participants were subjected to a treadmill exercise test during visits in years 0 and 20. Cardiorespiratory fitness was assessed based on the duration of treadmill exercise and the 20 year difference was used as a fitness measure.
The primary outcome was the development of bronchiectasis on chest CT scans done at year 25.
In year 25, 209 (9.6%) participants had bronchiectasis.
In multivariable models, maintenance of cardiorespiratory fitness during follow-up was less likely to have bronchiectasis at the time of the chest CT scan in year 25 (OR = 0.88; 95% CI, 0.8-0.98; P = 0.02) after adjusting for various associated confounding factors, including age, race, gender, study location, BMI, smoking status, history of tuberculosis, pneumonia, asthma, myocardial infarction, maximal lung function and cardiorespiratory fitness at baseline, according to the results. This model also showed an association with the change in cardiorespiratory fitness over 20 years and the severity of bronchiectasis with CT scores of 2 or less versus no bronchiectasis (OR = 0.88; 95% CI, 0.79-0.98; P = 0.02) and CT values greater than 2 against no bronchiectasis (OR = 0.83; 95% CI, 0.7-0.91; P = 0.02).
The researchers reported a consistent, strong association when cough and mucus were included in bronchiectasis (OR = 0.72; 95% CI, 0.59-0.87; P <0.001).
“Our results suggest that fitness may be a modifiable factor that can make a positive contribution to maintaining respiratory health,” the researchers wrote.
In an accompanying editorial, Dr. Jadranka Stojanovska, Assistant Professor in the Department of Radiology and Director of the Cardiothoracic MRI Program at Michigan Medicine at the University of Michigan, Ann Arbor: “[t]The sequence of these results suggests that high cardiorespiratory fitness reduces systemic and airway inflammation, improves the capacity and efficiency of cardiorespiratory systems with improved airway perfusion, including the mucociliary system, and therefore prevents the development of bronchiectasis.
“The underlying premise is that improving cardiorespiratory fitness provides unique opportunities for healthcare professionals to promote lifestyle-based strategies to reduce the risk of respiratory diseases, including bronchiectasis,” wrote Stojanovska.
Reference:
Stojanovska J. Radiology. 2021; doi: 10.1148 / radiol.2021210422.
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