Abstract
Rationale: Vascular alteration of small pulmonary vessels is one of the characteristic features of pulmonary hypertension in chronic obstructive pulmonary disease. The in vivo relationship between pulmonary hypertension and morphological alteration of the small pulmonary vessels has not been assessed in patients with severe emphysema. Objectives:Weevaluatedthecorrelationof total cross-sectional areaof small pulmonary vessels (CSA) assessed on computed tomography (CT) scans with the degree of pulmonary hypertension estimated by right heart catheterization. Methods: In 79 patients with severe emphysema enrolled in the National Emphysema Treatment Trial (NETT), we measured CSA less than 5 mm2 (CSA) and 5 to 10 mm2 (CSA 5-10), and calculated the percentage of total CSA for the lung area (%CSA and %CSA5-10, respectively). The correlations of %CSA and %CSA5-10 with pulmonary arterial mean pressure (Ppacombining overline) obtained by right heart catheterization were evaluated. Multiple linear regression analysis using Ppacombining overline as the dependent outcome was also performed. Measurements and Main Results:The%CSA had a significant negative correlation with Ppacombining overline (r= -0.512, P5-10 and Ppa did not reach statistical significance (r = -0.196, P = 0.083). Multiple linear regression analysis showed that %CSA and diffusing capacity of carbon monoxide (DLCO) % predicted were independent predictors of Ppacombining overline (r2 = 0.541):%CSA (P <0.0001), and DLCO % predicted (P = 0.022). Conclusions: The %CSA measured on CT images is significantly correlated to Ppacombining overline in severe emphysema and can estimate the degree of pulmonary hypertension.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 218-225 |
| Number of pages | 8 |
| Journal | American Journal of Respiratory and Critical Care Medicine |
| Volume | 181 |
| Issue number | 3 |
| DOIs | |
| State | Published - Feb 1 2010 |
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Keywords
- Chronic obstructive pulmonary disease
- CT
- Emphysema
- Pulmonary hypertension
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
Cite this
Pulmonary hypertension and computed tomography measurement of small pulmonary vessels in severe emphysema. / Matsuoka, Shin; Washko, George R.; Yamashiro, Tsuneo; Estepar, Raul San Jose; Diaz, Alejandro; Silverman, Edwin K.; Hoffman, Eric; Fessler, Henry Eric; Criner, Gerard J.; Marchetti, Nathaniel; Scharf, Steven M.; Martinez, Fernando J.; Reilly, John J.; Hatabu, Hiroto.
In: American Journal of Respiratory and Critical Care Medicine, Vol. 181, No. 3, 01.02.2010, p. 218-225.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Pulmonary hypertension and computed tomography measurement of small pulmonary vessels in severe emphysema
AU - Matsuoka, Shin
AU - Washko, George R.
AU - Yamashiro, Tsuneo
AU - Estepar, Raul San Jose
AU - Diaz, Alejandro
AU - Silverman, Edwin K.
AU - Hoffman, Eric
AU - Fessler, Henry Eric
AU - Criner, Gerard J.
AU - Marchetti, Nathaniel
AU - Scharf, Steven M.
AU - Martinez, Fernando J.
AU - Reilly, John J.
AU - Hatabu, Hiroto
PY - 2010/2/1
Y1 - 2010/2/1
N2 - Rationale: Vascular alteration of small pulmonary vessels is one of the characteristic features of pulmonary hypertension in chronic obstructive pulmonary disease. The in vivo relationship between pulmonary hypertension and morphological alteration of the small pulmonary vessels has not been assessed in patients with severe emphysema. Objectives:Weevaluatedthecorrelationof total cross-sectional areaof small pulmonary vessels (CSA) assessed on computed tomography (CT) scans with the degree of pulmonary hypertension estimated by right heart catheterization. Methods: In 79 patients with severe emphysema enrolled in the National Emphysema Treatment Trial (NETT), we measured CSA less than 5 mm2 (CSA) and 5 to 10 mm2 (CSA 5-10), and calculated the percentage of total CSA for the lung area (%CSA and %CSA5-10, respectively). The correlations of %CSA and %CSA5-10 with pulmonary arterial mean pressure (Ppacombining overline) obtained by right heart catheterization were evaluated. Multiple linear regression analysis using Ppacombining overline as the dependent outcome was also performed. Measurements and Main Results:The%CSA had a significant negative correlation with Ppacombining overline (r= -0.512, P5-10 and Ppa did not reach statistical significance (r = -0.196, P = 0.083). Multiple linear regression analysis showed that %CSA and diffusing capacity of carbon monoxide (DLCO) % predicted were independent predictors of Ppacombining overline (r2 = 0.541):%CSA (P <0.0001), and DLCO % predicted (P = 0.022). Conclusions: The %CSA measured on CT images is significantly correlated to Ppacombining overline in severe emphysema and can estimate the degree of pulmonary hypertension.
AB - Rationale: Vascular alteration of small pulmonary vessels is one of the characteristic features of pulmonary hypertension in chronic obstructive pulmonary disease. The in vivo relationship between pulmonary hypertension and morphological alteration of the small pulmonary vessels has not been assessed in patients with severe emphysema. Objectives:Weevaluatedthecorrelationof total cross-sectional areaof small pulmonary vessels (CSA) assessed on computed tomography (CT) scans with the degree of pulmonary hypertension estimated by right heart catheterization. Methods: In 79 patients with severe emphysema enrolled in the National Emphysema Treatment Trial (NETT), we measured CSA less than 5 mm2 (CSA) and 5 to 10 mm2 (CSA 5-10), and calculated the percentage of total CSA for the lung area (%CSA and %CSA5-10, respectively). The correlations of %CSA and %CSA5-10 with pulmonary arterial mean pressure (Ppacombining overline) obtained by right heart catheterization were evaluated. Multiple linear regression analysis using Ppacombining overline as the dependent outcome was also performed. Measurements and Main Results:The%CSA had a significant negative correlation with Ppacombining overline (r= -0.512, P5-10 and Ppa did not reach statistical significance (r = -0.196, P = 0.083). Multiple linear regression analysis showed that %CSA and diffusing capacity of carbon monoxide (DLCO) % predicted were independent predictors of Ppacombining overline (r2 = 0.541):%CSA (P <0.0001), and DLCO % predicted (P = 0.022). Conclusions: The %CSA measured on CT images is significantly correlated to Ppacombining overline in severe emphysema and can estimate the degree of pulmonary hypertension.
KW - Chronic obstructive pulmonary disease
KW - CT
KW - Emphysema
KW - Pulmonary hypertension
UR - http://www.scopus.com/inward/record.url?scp=76749108665&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=76749108665&partnerID=8YFLogxK
U2 - 10.1164/rccm.200908-1189OC
DO - 10.1164/rccm.200908-1189OC
M3 - Article
VL - 181
SP - 218
EP - 225
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
SN - 1073-449X
IS - 3
ER -