Chronic Obstructive Pulmonary Disase in WTC Workers - Diagnoses and Transitions

项目摘要 我们的长期目标是描述慢性下气道疾病的异质性组， 在世界贸易中心（WTC）工作人员和志愿者中观察到的疾病（LAD），揭示其风险因素， 合并症，识别具有不良和有利肺功能轨迹和结局的亚组，以及 开发和部署新的成像方法，以调查潜在的肺损伤。等 目标将反过来转化为更好地理解疾病的病理生理学，更有针对性， 个性化的，也许是改变疾病的治疗方法，以及改善的监测和 预防战略。 该项目的目标是描述慢性阻塞性肺疾病的转变 在世贸中心灾难现场的前工人和志愿者中发现了慢性阻塞性肺病（COPD）。根据我们的目标 我们的COPD病例的特征，我们的多学科调查小组建议建立 定量计算机断层扫描（QCT）特征，可区分WTC相关和非WTC相关 慢性阻塞性肺疾病（COPD）WTC相关性研究 并研究肺机械应变（LMS）作为肺损伤的早期QCT标志物 与慢性疾病和加速的纵向肺功能下降有关。 该项目将在西奈山的职业队列中进行。为此我们 将利用WTC肺评估单位胸部CT成像档案，一个大型的储存库， 1700名WTC工作人员的3000张胸部CT图像，以及与疾病症状相关的数据集，均为预处理 WTC和WTC相关职业暴露、详细肺功能和纵向肺功能测定 测量和体重趋势，视觉成像分类和分级，以及定量计算机 气道、身体成分以及肺实质和血管的断层扫描（QCT）测量 异常

Project Summary Our long-term goal has been to characterize the heterogeneous group of chronic lower airway diseases (LAD) observed in World Trade Center (WTC) workers and volunteers, uncover their risk factors and comorbidities, identify subgroups with adverse and favorable lung function trajectories and outcomes, and develop and deploy novel imaging approaches to the investigation of the lung injury underlying them. Such goal will in turn translate into better understanding of disease pathophysiology, more targeted, personalized, and perhaps disease modifying treatment approaches, and improved surveillance and prevention strategies. The goal of this project has been to characterize the transitions into chronic obstructive pulmonary disease (COPD) among former workers and volunteers at the WTC disaster site. Following our objective characterization of our COPD cases, our multidisciplinary investigative team proposes to establish the quantitative computed tomography (QCT) characteristics that may differentiate WTC-related from non- WTC-related COPD, investigate characteristics and longitudinal lung function trajectories of WTC patients with pre-COPD, and investigate lung mechanical strain (LMS) as an early QCT marker of lung injury associated with chronic disease and accelerated longitudinal lung function decline. This project will be conducted in the occupational cohort followed at Mount Sinai. To that end, we will utilize the WTC Pulmonary Evaluation Unit Chest CT Imaging Archive, a large repository with more than 3000 chest CT images on 1700 WTC workers, as well as linked datasets with disease symptoms, both pre- WTC and WTC-related occupational exposures, detailed pulmonary function and longitudinal spirometry measurements and body weight trends, visual imaging classification and grading, and quantitative computer tomography (QCT) measurements of airway, body composition, and pulmonary parenchymal and vascular abnormalities.