{
  "abstract": "Background Expiratory central airway collapse (ECAC) comprises tracheobronchomalacia and excessive dynamic airway collapse. ECAC is associated with an increased risk of hospitalisation and greater symptom burden in COPD. We aimed to assess the prevalence and, for the first time, longitudinal stability of ECAC in young smokers with preserved lung function.Methods We performed expiratory thoracic computed tomography (CT) scans at baseline and follow-up on current smokers aged 30–45 years old and with FEV 1 ≥80% predicted, as part of the British Early COPD Network (BEACON) study. Morphological airway measurements were made from the upper trachea to the lobar bronchi. ECAC was defined as a reduction of the cross-sectional area of a central airway (trachea or main bronchus) by >50%.Results 114 paired baseline and follow-up CT scans were evaluated (median age 40.2 years at baseline, median follow-up 5.4 years). The prevalence of ECAC was 5.3% (6/114) at baseline and 18.4% (21/114) at follow-up (P = 0.001). The degree of collapse of all the central airways increased on follow-up ( figure 1). 3/6 of participants with ECAC at baseline did not have it at follow-up. All of the participants who developed ECAC at follow-up maintained FEV1 ≥80% predicted.Abstract P257 Figure 1Conclusions The prevalence of ECAC increases longitudinally in young adult smokers despite preservation of their lung function. ECAC is dynamic in this patient group, meaning that serial assessments may be needed to diagnose it. Given the sequalae of ECAC in established COPD, further work is warranted to determine what drives increasing ECAC as young smokers age, so that appropriate preventive strategies can be identified.",
  "authors": [
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, UK"
      ],
      "name": "S Ananth"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, UK",
        "Royal Brompton Hospital, London, UK"
      ],
      "name": "C Ridge"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, UK"
      ],
      "name": "A Braddy-Green"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, UK"
      ],
      "name": "ANJM Marion"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, UK"
      ],
      "name": "LA Moreira"
    },
    {
      "affiliations": [
        "University of Manchester, Manchester, UK"
      ],
      "name": "A Beech"
    },
    {
      "affiliations": [
        "NIHR Nottingham Biomedical Research Centre, The University of Nottingham, Nottingham, UK"
      ],
      "name": "CE Bolton"
    },
    {
      "affiliations": [
        "Centre for Inflammatory Research, Queens Medical Research Institute, Edinburgh, UK"
      ],
      "name": "G Choudhury"
    },
    {
      "affiliations": [
        "Wellcome-Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast, UK"
      ],
      "name": "L McGarvey"
    },
    {
      "affiliations": [
        "University of Manchester, Manchester, UK"
      ],
      "name": "D Singh"
    },
    {
      "affiliations": [
        "Clinical and Experimental Sciences, University of Southampton, Southampton, UK"
      ],
      "name": "TM Wilkinson"
    },
    {
      "affiliations": [
        "AstraZeneca, Cambridge, UK"
      ],
      "name": "AI Ritchie"
    },
    {
      "affiliations": [
        "Chiesi Farmaceutici, Parma, Italy"
      ],
      "name": "M Govoni"
    },
    {
      "affiliations": [
        "GSK, Epping, UK"
      ],
      "name": "P Jones"
    },
    {
      "affiliations": [
        "AstraZeneca, Cambridge, UK"
      ],
      "name": "H Mullerova"
    },
    {
      "affiliations": [
        "AstraZeneca, Gothenberg, Sweden"
      ],
      "name": "K Ostridge"
    },
    {
      "affiliations": [
        "GSK, Epping, UK"
      ],
      "name": "JC Yates"
    },
    {
      "affiliations": [
        "Carver College of Medicine, University of Iowa, Iowa City, USA"
      ],
      "name": "EA Hoffman"
    },
    {
      "affiliations": [
        "University of Manchester, Manchester, UK"
      ],
      "name": "J Vestbo"
    },
    {
      "affiliations": [
        "University of Liverpool, Liverpool, UK"
      ],
      "name": "PM Calverley"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, UK"
      ],
      "name": "JA Wedzicha"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, UK",
        "Royal Brompton Hospital, London, UK"
      ],
      "name": "JP Allinson"
    },
    {
      "affiliations": [
        "British Early COPD Network (BEACON) Study, London, UK"
      ],
      "name": "British Early COPD Network (BEACON) Study"
    }
  ],
  "title": "P257 Expiratory central airway collapse increases longitudinally in young smokers with preserved lung function",
  "uid": "13a15dc3-d015-51cc-ac34-115b3efe0223"
}