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“Velcro-type” crackles predict specific radiologic features of fibrotic interstitial lung disease

“Velcro-type” crackles predict specific radiologic features of fibrotic interstitial lung disease
“Velcro-type” crackles predict specific radiologic features of fibrotic interstitial lung disease
Background: “Velcro-type” crackles on chest auscultation are considered a typical acoustic finding of Fibrotic Interstitial Lung Disease (FILD), however whether they may have a role in the early detection of these disorders has been unknown. This study investigated how “Velcro-type” crackles correlate with the presence of distinct patterns of FILD and individual radiologic features of pulmonary fibrosis on High Resolution Computed Tomography (HRCT).

Methods: lung sounds were digitally recorded from subjects immediately prior to undergoing clinically indicated chest HRCT. Audio files were independently assessed by two chest physicians and both full volume and single HRCT sections corresponding to the recording sites were extracted. The relationships between audible “Velcro-type” crackles and radiologic HRCT patterns and individual features of pulmonary fibrosis were investigated using multivariate regression models.

Results: 148 subjects were enrolled: bilateral “Velcro-type” crackles predicted the presence of FILD at HRCT (OR 13.46, 95% CI 5.85–30.96, p < 0.001) and most strongly the Usual Interstitial Pneumonia (UIP) pattern (OR 19.8, 95% CI 5.28–74. 25, p < 0.001). Extent of isolated reticulation (OR 2.04, 95% CI 1.62–2.57, p < 0.001), honeycombing (OR 1.88, 95% CI 1. 24–2.83, < 0.01), ground glass opacities (OR 1.74, 95% CI 1.29–2.32, p < 0.001) and traction bronchiectasis (OR 1.55, 95% CI 1.03–2.32, p < 0.05) were all independently associated with the presence of “Velcro-type” crackles.

Conclusions: “Velcro-type” crackles predict the presence of FILD and directly correlate with the extent of distinct radiologic features of pulmonary fibrosis. Such evidence provides grounds for further investigation of lung sounds as an early identification tool in FILD.
1471-2466
Sgalla, Giacomo
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Walsh, Simon
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Sverzellati, Nicola
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Fletcher, Sophie
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Cerri, Stefania
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Dimitrov, Borislav
366d715f-ffd9-45a1-8415-65de5488472f
Nikolic, Dragana
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Barney, Anna
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Pancaldi, Fabrizio
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Larcher, Luca
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Luppi, Fabrizio
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Jones, Mark
a6fd492e-058e-4e84-a486-34c6035429c1
Davies, Donna
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Richeldi, Luca
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Sgalla, Giacomo
a827a8c4-77f9-4d0e-bc08-a1aa01ffdf5a
Walsh, Simon
60209c1f-ede5-47bf-b112-32442e61263a
Sverzellati, Nicola
03bddd86-a6f5-44e6-898f-3cfad8e2390c
Fletcher, Sophie
92048e5c-6c10-4572-ab69-81601e9cb0f2
Cerri, Stefania
dfc5fe4f-408f-4f6c-8c67-b212a5d97d3f
Dimitrov, Borislav
366d715f-ffd9-45a1-8415-65de5488472f
Nikolic, Dragana
772b3eb2-c994-440a-ab86-27e862bd39f7
Barney, Anna
bc0ee7f7-517a-4154-ab7d-57270de3e815
Pancaldi, Fabrizio
3a015fe7-9b52-47d1-ad93-0ddecb085dc9
Larcher, Luca
85cfa95d-1480-41c0-8961-7ae95c64b665
Luppi, Fabrizio
7da8f1e6-4f08-4bcb-ae57-8bb3ce9032a5
Jones, Mark
a6fd492e-058e-4e84-a486-34c6035429c1
Davies, Donna
7de8fdc7-3640-4e3a-aa91-d0e03f990c38
Richeldi, Luca
47177d9c-731a-49a1-9cc6-4ac8f6bbbf26

Sgalla, Giacomo, Walsh, Simon, Sverzellati, Nicola, Fletcher, Sophie, Cerri, Stefania, Dimitrov, Borislav, Nikolic, Dragana, Barney, Anna, Pancaldi, Fabrizio, Larcher, Luca, Luppi, Fabrizio, Jones, Mark, Davies, Donna and Richeldi, Luca (2018) “Velcro-type” crackles predict specific radiologic features of fibrotic interstitial lung disease. BMC Pulmonary Medicine. (doi:10.1186/s12890-018-0670-0).

Record type: Article

Abstract

Background: “Velcro-type” crackles on chest auscultation are considered a typical acoustic finding of Fibrotic Interstitial Lung Disease (FILD), however whether they may have a role in the early detection of these disorders has been unknown. This study investigated how “Velcro-type” crackles correlate with the presence of distinct patterns of FILD and individual radiologic features of pulmonary fibrosis on High Resolution Computed Tomography (HRCT).

Methods: lung sounds were digitally recorded from subjects immediately prior to undergoing clinically indicated chest HRCT. Audio files were independently assessed by two chest physicians and both full volume and single HRCT sections corresponding to the recording sites were extracted. The relationships between audible “Velcro-type” crackles and radiologic HRCT patterns and individual features of pulmonary fibrosis were investigated using multivariate regression models.

Results: 148 subjects were enrolled: bilateral “Velcro-type” crackles predicted the presence of FILD at HRCT (OR 13.46, 95% CI 5.85–30.96, p < 0.001) and most strongly the Usual Interstitial Pneumonia (UIP) pattern (OR 19.8, 95% CI 5.28–74. 25, p < 0.001). Extent of isolated reticulation (OR 2.04, 95% CI 1.62–2.57, p < 0.001), honeycombing (OR 1.88, 95% CI 1. 24–2.83, < 0.01), ground glass opacities (OR 1.74, 95% CI 1.29–2.32, p < 0.001) and traction bronchiectasis (OR 1.55, 95% CI 1.03–2.32, p < 0.05) were all independently associated with the presence of “Velcro-type” crackles.

Conclusions: “Velcro-type” crackles predict the presence of FILD and directly correlate with the extent of distinct radiologic features of pulmonary fibrosis. Such evidence provides grounds for further investigation of lung sounds as an early identification tool in FILD.

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Accepted/In Press date: 12 June 2018
e-pub ahead of print date: 18 June 2018

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Local EPrints ID: 421886
URI: https://eprints.soton.ac.uk/id/eprint/421886
ISSN: 1471-2466
PURE UUID: 83bb8ecc-7f53-4270-982b-e08992f74ecb
ORCID for Anna Barney: ORCID iD orcid.org/0000-0002-6034-1478

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Date deposited: 05 Jul 2018 16:30
Last modified: 14 Jul 2018 00:35

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Contributors

Author: Giacomo Sgalla
Author: Simon Walsh
Author: Nicola Sverzellati
Author: Sophie Fletcher
Author: Stefania Cerri
Author: Borislav Dimitrov
Author: Dragana Nikolic
Author: Anna Barney ORCID iD
Author: Fabrizio Pancaldi
Author: Luca Larcher
Author: Fabrizio Luppi
Author: Mark Jones
Author: Donna Davies
Author: Luca Richeldi

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