Percent emphysema, airflow obstruction, and impaired left ventricular filling

R. Graham Barr, David A. Bluemke, Firas S. Ahmed, J. Jeffery Carr, Paul L. Enright, Eric A. Hoffman, Rui Jiang, Steven M. Kawut, Richard A. Kronmal, Joao Lima, Eyal Shahar, Lewis J. Smith, Karol E. Watson

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Very severe chronic obstructive pulmonary disease causes cor pulmonale with elevated pulmonary vascular resistance and secondary reductions in left ventricular filling, stroke volume, and cardiac output. We hypothesized that emphysema, as detected on computed tomography (CT), and airflow obstruction are inversely related to left ventricular end-diastolic volume, stroke volume, and cardiac output among persons without very severe lung disease. METHODS: We measured left ventricular structure and function with the use of magnetic resonance imaging in 2816 persons who were 45 to 84 years of age. The extent of emphysema (expressed as percent emphysema) was defined as the percentage of voxels below -910 Hounsfield units in the lung windows on cardiac computed tomographic scans. Spirometry was performed according to American Thoracic Society guidelines. Generalized additive models were used to test for threshold effects. RESULTS: Of the study participants, 13% were current smokers, 38% were former smokers, and 49% had never smoked. A 10-point increase in percent emphysema was linearly related to reductions in left ventricular end-diastolic volume (-4.1 ml; 95% confidence interval [CI], -3.3 to -4.9; P

Original languageEnglish (US)
Pages (from-to)217-227
Number of pages11
JournalNew England Journal of Medicine
Volume362
Issue number3
DOIs
StatePublished - Jan 21 2010

Fingerprint

Emphysema
Stroke Volume
Cardiac Output
Pulmonary Heart Disease
Spirometry
Left Ventricular Function
Vascular Resistance
Chronic Obstructive Pulmonary Disease
Lung Diseases
Tomography
Magnetic Resonance Imaging
Guidelines
Confidence Intervals
Lung

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Barr, R. G., Bluemke, D. A., Ahmed, F. S., Carr, J. J., Enright, P. L., Hoffman, E. A., ... Watson, K. E. (2010). Percent emphysema, airflow obstruction, and impaired left ventricular filling. New England Journal of Medicine, 362(3), 217-227. https://doi.org/10.1056/NEJMoa0808836

Percent emphysema, airflow obstruction, and impaired left ventricular filling. / Barr, R. Graham; Bluemke, David A.; Ahmed, Firas S.; Carr, J. Jeffery; Enright, Paul L.; Hoffman, Eric A.; Jiang, Rui; Kawut, Steven M.; Kronmal, Richard A.; Lima, Joao; Shahar, Eyal; Smith, Lewis J.; Watson, Karol E.

In: New England Journal of Medicine, Vol. 362, No. 3, 21.01.2010, p. 217-227.

Research output: Contribution to journalArticle

Barr, RG, Bluemke, DA, Ahmed, FS, Carr, JJ, Enright, PL, Hoffman, EA, Jiang, R, Kawut, SM, Kronmal, RA, Lima, J, Shahar, E, Smith, LJ & Watson, KE 2010, 'Percent emphysema, airflow obstruction, and impaired left ventricular filling', New England Journal of Medicine, vol. 362, no. 3, pp. 217-227. https://doi.org/10.1056/NEJMoa0808836
Barr RG, Bluemke DA, Ahmed FS, Carr JJ, Enright PL, Hoffman EA et al. Percent emphysema, airflow obstruction, and impaired left ventricular filling. New England Journal of Medicine. 2010 Jan 21;362(3):217-227. https://doi.org/10.1056/NEJMoa0808836
Barr, R. Graham ; Bluemke, David A. ; Ahmed, Firas S. ; Carr, J. Jeffery ; Enright, Paul L. ; Hoffman, Eric A. ; Jiang, Rui ; Kawut, Steven M. ; Kronmal, Richard A. ; Lima, Joao ; Shahar, Eyal ; Smith, Lewis J. ; Watson, Karol E. / Percent emphysema, airflow obstruction, and impaired left ventricular filling. In: New England Journal of Medicine. 2010 ; Vol. 362, No. 3. pp. 217-227.
@article{27ec9e69e0374e5fb824b441ba6bb0fe,
title = "Percent emphysema, airflow obstruction, and impaired left ventricular filling",
abstract = "BACKGROUND: Very severe chronic obstructive pulmonary disease causes cor pulmonale with elevated pulmonary vascular resistance and secondary reductions in left ventricular filling, stroke volume, and cardiac output. We hypothesized that emphysema, as detected on computed tomography (CT), and airflow obstruction are inversely related to left ventricular end-diastolic volume, stroke volume, and cardiac output among persons without very severe lung disease. METHODS: We measured left ventricular structure and function with the use of magnetic resonance imaging in 2816 persons who were 45 to 84 years of age. The extent of emphysema (expressed as percent emphysema) was defined as the percentage of voxels below -910 Hounsfield units in the lung windows on cardiac computed tomographic scans. Spirometry was performed according to American Thoracic Society guidelines. Generalized additive models were used to test for threshold effects. RESULTS: Of the study participants, 13{\%} were current smokers, 38{\%} were former smokers, and 49{\%} had never smoked. A 10-point increase in percent emphysema was linearly related to reductions in left ventricular end-diastolic volume (-4.1 ml; 95{\%} confidence interval [CI], -3.3 to -4.9; P",
author = "Barr, {R. Graham} and Bluemke, {David A.} and Ahmed, {Firas S.} and Carr, {J. Jeffery} and Enright, {Paul L.} and Hoffman, {Eric A.} and Rui Jiang and Kawut, {Steven M.} and Kronmal, {Richard A.} and Joao Lima and Eyal Shahar and Smith, {Lewis J.} and Watson, {Karol E.}",
year = "2010",
month = "1",
day = "21",
doi = "10.1056/NEJMoa0808836",
language = "English (US)",
volume = "362",
pages = "217--227",
journal = "New England Journal of Medicine",
issn = "0028-4793",
publisher = "Massachussetts Medical Society",
number = "3",

}

TY - JOUR

T1 - Percent emphysema, airflow obstruction, and impaired left ventricular filling

AU - Barr, R. Graham

AU - Bluemke, David A.

AU - Ahmed, Firas S.

AU - Carr, J. Jeffery

AU - Enright, Paul L.

AU - Hoffman, Eric A.

AU - Jiang, Rui

AU - Kawut, Steven M.

AU - Kronmal, Richard A.

AU - Lima, Joao

AU - Shahar, Eyal

AU - Smith, Lewis J.

AU - Watson, Karol E.

PY - 2010/1/21

Y1 - 2010/1/21

N2 - BACKGROUND: Very severe chronic obstructive pulmonary disease causes cor pulmonale with elevated pulmonary vascular resistance and secondary reductions in left ventricular filling, stroke volume, and cardiac output. We hypothesized that emphysema, as detected on computed tomography (CT), and airflow obstruction are inversely related to left ventricular end-diastolic volume, stroke volume, and cardiac output among persons without very severe lung disease. METHODS: We measured left ventricular structure and function with the use of magnetic resonance imaging in 2816 persons who were 45 to 84 years of age. The extent of emphysema (expressed as percent emphysema) was defined as the percentage of voxels below -910 Hounsfield units in the lung windows on cardiac computed tomographic scans. Spirometry was performed according to American Thoracic Society guidelines. Generalized additive models were used to test for threshold effects. RESULTS: Of the study participants, 13% were current smokers, 38% were former smokers, and 49% had never smoked. A 10-point increase in percent emphysema was linearly related to reductions in left ventricular end-diastolic volume (-4.1 ml; 95% confidence interval [CI], -3.3 to -4.9; P

AB - BACKGROUND: Very severe chronic obstructive pulmonary disease causes cor pulmonale with elevated pulmonary vascular resistance and secondary reductions in left ventricular filling, stroke volume, and cardiac output. We hypothesized that emphysema, as detected on computed tomography (CT), and airflow obstruction are inversely related to left ventricular end-diastolic volume, stroke volume, and cardiac output among persons without very severe lung disease. METHODS: We measured left ventricular structure and function with the use of magnetic resonance imaging in 2816 persons who were 45 to 84 years of age. The extent of emphysema (expressed as percent emphysema) was defined as the percentage of voxels below -910 Hounsfield units in the lung windows on cardiac computed tomographic scans. Spirometry was performed according to American Thoracic Society guidelines. Generalized additive models were used to test for threshold effects. RESULTS: Of the study participants, 13% were current smokers, 38% were former smokers, and 49% had never smoked. A 10-point increase in percent emphysema was linearly related to reductions in left ventricular end-diastolic volume (-4.1 ml; 95% confidence interval [CI], -3.3 to -4.9; P

UR - http://www.scopus.com/inward/record.url?scp=74849116683&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=74849116683&partnerID=8YFLogxK

U2 - 10.1056/NEJMoa0808836

DO - 10.1056/NEJMoa0808836

M3 - Article

VL - 362

SP - 217

EP - 227

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 0028-4793

IS - 3

ER -