Potential Role of CT Metrics in Chronic Obstructive Pulmonary Disease with Pulmonary Hypertension

被引:13
作者
Ando, Katsutoshi [1 ]
Kuraishi, Hiroshi [2 ]
Nagaoka, Tetsutaro [1 ]
Tsutsumi, Takeo [1 ]
Hoshika, Yoshito [3 ]
Kimura, Toru [4 ]
Ienaga, Hiroki [3 ]
Morio, Yoshiteru [1 ]
Takahashi, Kazuhisa [1 ]
机构
[1] Juntendo Univ, Grad Sch Med, Div Resp Med,Dept Internal Med, Bunkyo Ku, Tokyo 1138421, Japan
[2] Nagano Red Cross Hosp, Dept Pulmonol, Nagano, Nagano 3808582, Japan
[3] Koshigaya Municipal Hosp, Dept Pulmonol, Koshigaya, Saitama 3438577, Japan
[4] Koshigaya Municipal Hosp, Dept Cardiovasc Med, Koshigaya, Saitama 3438577, Japan
关键词
Chronic obstructive pulmonary disease; Computed tomography; Pulmonary hypertension; Pulmonary vasodilator; EMPHYSEMA; FIBROSIS; COPD; SILDENAFIL; EXPRESSION; ARTERIES; VESSELS; SMOKERS;
D O I
10.1007/s00408-015-9813-8
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Purpose Recent imaging studies demonstrated the usefulness of quantitative computed tomographic (CT) analysis assessing pulmonary hypertension (PH) in patients with chronic obstructive lung disease (COPD-PH). The aim of this study was to investigate whether it would be also valuable for predicting and evaluating the effect of pulmonary vasodilators in patients with COPD-PH. Methods We analyzed a correlation between the extent of cystic destruction (LAA%) and total cross-sectional areas of small pulmonary vessels less than 5 mm(2) (%CSA < 5) in many CT slices from each of four COPD-PH patients before and after the initiation of pulmonary vasodilator. To evaluate those generalized data from patients with COPD, we evaluated multiple slices from 42 patients whose PH was not clinically suspicious. We also selected five PH patients with idiopathic interstitial pneumonia (IIP-PH) and analyzed serial changes of pulmonary artery enlargement (PA:A ratio). Results In 42 COPD patients without PH, LAA% had a statistically significant negative correlation with %CSA < 5. However, three of four COPD-PH patients manifested no such correlation. In two patients, clinical findings were dramatically improved after the initiation of pulmonary vasodilator. Notably, LAA% and %CSA < 5 in those patients correlated significantly after its treatment. In COPD-PH, the PA:A ratio was significantly decreased after the initiation of pulmonary vasodilator therapy (1.25 +/- A 0.13 vs. 1.13 +/- A 0.11, p = 0.019), but not in IIP-PH. Conclusions Our study demonstrates that the use of quantitative CT analysis is a plausible and beneficial tool for predicting and evaluating the effect of pulmonary vasodilators in patients with COPD-PH.
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收藏
页码:911 / 918
页数:8
相关论文
共 16 条
  • [11] 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 E.
    Criner, Gerard J.
    Marchetti, Nathaniel
    Scharf, Steven M.
    Martinez, Fernando J.
    Reilly, John J.
    Hatabu, Hiroto
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2010, 181 (03) : 218 - 225
  • [12] Sildenafil treatment in COPD does not affect stroke volume or exercise capacity
    Rietema, H.
    Holverda, S.
    Bogaard, H. J.
    Marcus, J. T.
    Smit, H. J.
    Westerhof, N.
    Postmus, P. E.
    Boonstra, A.
    Vonk-Noordegraaf, A.
    [J]. EUROPEAN RESPIRATORY JOURNAL, 2008, 31 (04) : 759 - 764
  • [13] Enhanced expression of vascular endothelial growth factor in pulmonary arteries of smokers and patients with moderate chronic obstructive pulmonary disease
    Santos, S
    Peinado, VI
    Ramírez, J
    Morales-Blanhir, J
    Bastos, R
    Roca, J
    Rodriguez-Roisin, R
    Barberà, JA
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2003, 167 (09) : 1250 - 1256
  • [14] A randomised, controlled trial of bosentan in severe COPD
    Stolz, D.
    Rasch, H.
    Linka, A.
    Di Valentino, M.
    Meyer, A.
    Brutsche, M.
    Tamm, M.
    [J]. EUROPEAN RESPIRATORY JOURNAL, 2008, 32 (03) : 619 - 628
  • [15] The revised ATS/ERS/JRS/ALAT diagnostic criteria for idiopathic pulmonary fibrosis (IPF) - practical implications
    Wells, Athol U.
    [J]. RESPIRATORY RESEARCH, 2013, 14
  • [16] Pulmonary Arterial Enlargement and Acute Exacerbations of COPD
    Wells, J. Michael
    Washko, George R.
    Han, MeiLan K.
    Abbas, Naseer
    Nath, Hrudaya
    Mamary, A. James
    Regan, Elizabeth
    Bailey, William C.
    Martinez, Fernando J.
    Westfall, Elizabeth
    Beaty, Terri H.
    Curran-Everett, Douglas
    Curtis, Jeffrey L.
    Hokanson, John E.
    Lynch, David A.
    Make, Barry J.
    Crapo, James D.
    Silverman, Edwin K.
    Bowler, Russell P.
    Dransfield, Mark T.
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2012, 367 (10) : 913 - 921