Loading...
Please wait, while we are loading the content...
Similar Documents
Pulmonary artery to aorta ratio is associated with cardiac structure and functional changes in mild-to-moderate COPD
| Content Provider | Scilit |
|---|---|
| Author | Cuttica, Michael J. Bhatt, Surya P. Rosenberg, Sharon R. Beussink, Lauren Shah, Sanjiv Smith, Lewis J. Dransfield, Mark T. Kalhan, Ravi |
| Copyright Year | 2017 |
| Abstract | Pulmonary artery to aorta ratio is associated with cardiac structure and functional changes in mild-to-moderate COPD Michael J Cuttica,1 Surya P Bhatt,2 Sharon R Rosenberg,1 Lauren Beussink,3 Sanjiv J Shah,3 Lewis J Smith,1 Mark T Dransfield,2 Ravi Kalhan1 1Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 2Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama-Birmingham, Birmingham, AL, 3Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Background: The ratio of the diameter of the pulmonary artery (PA) to the diameter of the aorta (PA:A) on computed tomography (CT) imaging is associated with both COPD exacerbation and pulmonary hypertension. The mechanisms of PA enlargement in COPD are poorly understood. Methods: In this retrospective, single center study we evaluated pulmonary function, CT scans, right heart catheterizations, and echocardiography in 88 subjects with mild-to-moderately severe COPD. A sensitivity analysis was performed in 43 subjects in whom CT scan and echocardiogram were performed within 50 days of each other. To evaluate the association between PA:A ratio and echocardiographic parameters and hemodynamics, we performed simple correlations and multivariable linear regression analysis adjusting for lung function, age, sex, race, and diastolic function. Results: All subjects had preserved left ventricular (LV) systolic function (LV ejection fraction 62.7%±5.5%). Among them, 56.8% had evidence of diastolic dysfunction. There was no association between PA:A ratio and the presence of diastolic dysfunction. In a multivariable model, PA:A ratio was associated with right ventricular (RV) chamber size (β=0.015; P<0.003), RV wall thickness (β=0.56; P<0.002), and RV function (–0.49; P=0.05). In the subgroup of subjects with testing within 50 days, the association with RV chamber size persisted (β=0.017; P=0.04), as did the lack of association with diastolic function. PA:A ratio was also associated with elevated PA systolic pressures (r=0.62; P=0.006) and pulmonary vascular resistance (r=0.46; P=0.05), but not pulmonary arterial wedge pressure (r=0.17; P=0.5) in a subset of patients undergoing right heart catheterization. Conclusion: In patients with mild-to-moderately severe COPD and preserved LV function, increased PA:A ratio occurs independent of LV diastolic dysfunction. Furthermore, the PA:A ratio is associated with right heart structure and function changes, as well as pulmonary hemodynamics. These findings indicate that PA:A ratio is a marker of intrinsic pulmonary vascular changes rather than impaired LV filling. Keywords: COPD, diastolic dysfunction, pulmonary artery |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439958/pdf https://www.dovepress.com/getfile.php?fileID=36467 |
| Ending Page | 1446 |
| Page Count | 8 |
| Starting Page | 1439 |
| ISSN | 11769106 |
| e-ISSN | 11782005 |
| DOI | 10.2147/copd.s131413 |
| Journal | International journal of chronic obstructive pulmonary disease |
| Volume Number | 12 |
| Language | English |
| Publisher | Informa UK Limited |
| Publisher Date | 2017-05-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: International Journal of Chronic Obstructive Pulmonary Disease Respiratory System Copd Diastolic Dysfunction Pulmonary Artery |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pulmonary and Respiratory Medicine Public Health, Environmental and Occupational Health Health Policy |
