Katsutoshi Ando1, Hiroshi Kuraishi2, Tetsutaro Nagaoka3, Takeo Tsutsumi3, Yoshito Hoshika4, Toru Kimura5, Hiroki Ienaga4, Yoshiteru Morio3, Kazuhisa Takahashi3. 1. Division of Respiratory Medicine, Department of Internal Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan. kando@juntendo.ac.jp. 2. Department of Pulmonology, Nagano Red Cross Hospital, 5-22-1 Wakasato, Nagano, Nagano, 380-8582, Japan. 3. Division of Respiratory Medicine, Department of Internal Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan. 4. Department of Pulmonology, Koshigaya Municipal Hospital, 10-47 Higashi-koshigaya, Koshigaya, Saitama, 343-8577, Japan. 5. Department of Cardiovascular Medicine, Koshigaya Municipal Hospital, 10-47 Higashi-koshigaya, Koshigaya, Saitama, 343-8577, Japan.
Abstract
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 ± 0.13 vs. 1.13 ± 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.
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 ± 0.13 vs. 1.13 ± 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.
Authors: Gaël Dournes; François Laurent; Florence Coste; Claire Dromer; Elodie Blanchard; François Picard; Fabien Baldacci; Michel Montaudon; Pierre-Olivier Girodet; Roger Marthan; Patrick Berger Journal: Am J Respir Crit Care Med Date: 2015-01-01 Impact factor: 21.405
Authors: Salud Santos; Victor I Peinado; Josep Ramirez; Jaime Morales-Blanhir; Ricardo Bastos; Josep Roca; Robert Rodriguez-Roisin; Joan A Barbera Journal: Am J Respir Crit Care Med Date: 2003-02-20 Impact factor: 21.405
Authors: R Graham Barr; Sonia Mesia-Vela; John H M Austin; Robert C Basner; Brad M Keller; Anthony P Reeves; Daichi Shimbo; Lori Stevenson Journal: Am J Respir Crit Care Med Date: 2007-08-29 Impact factor: 21.405
Authors: H Rietema; S Holverda; H J Bogaard; J T Marcus; H J Smit; N Westerhof; P E Postmus; A Boonstra; A Vonk-Noordegraaf Journal: Eur Respir J Date: 2007-12-19 Impact factor: 16.671
Authors: Isabel Blanco; Elena Gimeno; Phillip A Munoz; Sandra Pizarro; Concepción Gistau; Robert Rodriguez-Roisin; Josep Roca; Joan Albert Barberà Journal: Am J Respir Crit Care Med Date: 2009-10-29 Impact factor: 21.405
Authors: Julia Hoffmann; Jochen Wilhelm; Leigh M Marsh; Bahil Ghanim; Walter Klepetko; Gabor Kovacs; Horst Olschewski; Andrea Olschewski; Grazyna Kwapiszewska Journal: Am J Respir Crit Care Med Date: 2014-07-01 Impact factor: 21.405
Authors: Danilo Tadao Wada; Adriana Ignácio de Pádua; Moyses Oliveira Lima Filho; José Antonio Marin Neto; Jorge Elias Júnior; José Baddini-Martinez; Marcel Koenigkam Santos Journal: Radiol Bras Date: 2017 Nov-Dec
Authors: Firdaus A Mohamed Hoesein; Tim Besselink; Esther Pompe; Erik-Jan Oudijk; Ed A de Graaf; J M Kwakkel-van Erp; Pim A de Jong; Bart Luijk Journal: Lung Date: 2016-07-16 Impact factor: 2.584