Severe pulmonary hypertension associated with lung disease is characterised by a loss of small pulmonary vessels on quantitative computed tomography.
Journal
ERJ open research
ISSN: 2312-0541
Titre abrégé: ERJ Open Res
Pays: England
ID NLM: 101671641
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
received:
13
08
2021
accepted:
10
02
2022
entrez:
19
5
2022
pubmed:
20
5
2022
medline:
20
5
2022
Statut:
epublish
Résumé
Pulmonary hypertension (PH) in patients with chronic lung disease (CLD) predicts reduced functional status, clinical worsening and increased mortality, with patients with severe PH-CLD (≥35 mmHg) having a significantly worse prognosis than mild to moderate PH-CLD (21-34 mmHg). The aim of this cross-sectional study was to assess the association between computed tomography (CT)-derived quantitative pulmonary vessel volume, PH severity and disease aetiology in CLD. Treatment-naïve patients with CLD who underwent CT pulmonary angiography, lung function testing and right heart catheterisation were identified from the ASPIRE registry between October 2012 and July 2018. Quantitative assessments of total pulmonary vessel and small pulmonary vessel volume were performed. 90 patients had PH-CLD including 44 associated with COPD/emphysema and 46 with interstitial lung disease (ILD). Patients with severe PH-CLD (n=40) had lower small pulmonary vessel volume compared to patients with mild to moderate PH-CLD (n=50). Patients with PH-ILD had significantly reduced small pulmonary blood vessel volume, compared to PH-COPD/emphysema. Higher mortality was identified in patients with lower small pulmonary vessel volume. Patients with severe PH-CLD, regardless of aetiology, have lower small pulmonary vessel volume compared to patients with mild-moderate PH-CLD, and this is associated with a higher mortality. Whether pulmonary vessel changes quantified by CT are a marker of remodelling of the distal pulmonary vasculature requires further study.
Sections du résumé
Background
UNASSIGNED
Pulmonary hypertension (PH) in patients with chronic lung disease (CLD) predicts reduced functional status, clinical worsening and increased mortality, with patients with severe PH-CLD (≥35 mmHg) having a significantly worse prognosis than mild to moderate PH-CLD (21-34 mmHg). The aim of this cross-sectional study was to assess the association between computed tomography (CT)-derived quantitative pulmonary vessel volume, PH severity and disease aetiology in CLD.
Methods
UNASSIGNED
Treatment-naïve patients with CLD who underwent CT pulmonary angiography, lung function testing and right heart catheterisation were identified from the ASPIRE registry between October 2012 and July 2018. Quantitative assessments of total pulmonary vessel and small pulmonary vessel volume were performed.
Results
UNASSIGNED
90 patients had PH-CLD including 44 associated with COPD/emphysema and 46 with interstitial lung disease (ILD). Patients with severe PH-CLD (n=40) had lower small pulmonary vessel volume compared to patients with mild to moderate PH-CLD (n=50). Patients with PH-ILD had significantly reduced small pulmonary blood vessel volume, compared to PH-COPD/emphysema. Higher mortality was identified in patients with lower small pulmonary vessel volume.
Conclusion
UNASSIGNED
Patients with severe PH-CLD, regardless of aetiology, have lower small pulmonary vessel volume compared to patients with mild-moderate PH-CLD, and this is associated with a higher mortality. Whether pulmonary vessel changes quantified by CT are a marker of remodelling of the distal pulmonary vasculature requires further study.
Identifiants
pubmed: 35586449
doi: 10.1183/23120541.00503-2021
pii: 00503-2021
pmc: PMC9108962
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : Wellcome Trust
ID : 205188/Z/16/Z
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/M008894/1
Pays : United Kingdom
Organisme : British Heart Foundation
ID : SP/14/6/31350
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 206632/Z/17/Z
Pays : United Kingdom
Organisme : British Heart Foundation
ID : FS/18/13/33281
Pays : United Kingdom
Informations de copyright
Copyright ©The authors 2022.
Déclaration de conflit d'intérêts
Conflict of interest: D. Alkhanfar has nothing to disclose. Conflict of interest: Y. Shahin has nothing to disclose. Conflict of interest: F. Alandejani has nothing to disclose. Conflict of interest: K. Dwivedi has nothing to disclose. Conflict of interest: S. Alabed has nothing to disclose. Conflict of interest: C. Johns has nothing to disclose. Conflict of interest: A. Lawrie has nothing to disclose. Conflict of interest: A.A.R. Thompson has nothing to disclose. Conflict of interest: A.M.K. Rothman has nothing to disclose. Conflict of interest: J. Tschirren has nothing to disclose. Conflict of interest: J.M. Uthoff has nothing to disclose. Conflict of interest: E. Hoffman has nothing to disclose. Conflict of interest: R. Condliffe has nothing to disclose. Conflict of interest: J.M. Wild has nothing to disclose. Conflict of interest: D.G. Kiely has nothing to disclose. Conflict of interest: A.J. Swift has nothing to disclose.
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