Chia-Ying Liu1,2, Megha Parikh3, David A Bluemke1,2, Pallavi Balte1, James Carr4, Stephen Dashnaw5, Hooman D Poor6, Antoinette S Gomes7, Eric A Hoffman8, Steven M Kawut9, Joao A C Lima1, David A McAllister10, Martin A Prince5,11, Jens Vogel-Claussen12, R Graham Barr3,13. 1. Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland, USA. 2. Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Maryland, USA. 3. Department of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, New York, USA. 4. Department of Radiology, Northwestern University, Chicago, Illinois, USA. 5. Department of Radiology, College of Physicians and Surgeons, Columbia University Medical Center, New York, New York, USA. 6. Division of Pulmonary, Critical Care and Sleep Medicine, Mount Sinai-National Jewish Health Respiratory Institute, New York, New York, USA. 7. Department of Medicine, University of California, Los Angeles, Los Angeles, California, USA. 8. Department of Radiology, University of Iowa, Iowa City, Iowa, USA. 9. Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 10. Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom. 11. Department of Radiology, Weill Cornell Medical College, New York, New York, USA. 12. Hannover Medical School, Hannover, Germany. 13. Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, New York, USA.
Abstract
PURPOSE: Chronic obstructive pulmonary disease (COPD) and particularly emphysema are characterized by stiffness of the aorta, due in part to accelerated elastin degradation in the lungs and aorta. Stiffness of the pulmonary arteries (PAs) may also be increased in COPD and emphysema, but data are lacking. We assessed PA stiffness using MRI in patients with COPD and related these measurements to COPD severity and percent emphysema. MATERIALS AND METHODS: The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study recruited 290 participants, age 50-79 years with 10 or more packyears and free of clinical cardiovascular disease. COPD severity were defined on postbronchodilator spirometry by ATS/ERS criteria. Percent emphysema was defined as the percentage of regions of the lung < -950 Hounsfield units on full-lung computed tomography (CT). PA stain was defined by the percent change in cross-sectional PA area between systole and diastole on MRI. Blood flow across the tricuspid and mitral valves was assessed by phase-contrast MRI for determination of the ventricular diastolic dysfunction (E/A ratio). RESULTS: PA strain was reduced in COPD compared with controls (P = 0.002) and was inversely correlated with COPD severity (P = 0.004). PA strain was inversely associated to percent emphysema (P = 0.01). PA strain was also markedly correlated with right ventricular diastolic dysfunction measured by E/A ratios in the fully adjusted mix models (P = 0.02). CONCLUSION: PA strain is reduced in COPD, related in part to percent emphysema on CT scan, which may have implications for pulmonary small vessel flow and right ventricular function. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:262-271.
PURPOSE:Chronic obstructive pulmonary disease (COPD) and particularly emphysema are characterized by stiffness of the aorta, due in part to accelerated elastin degradation in the lungs and aorta. Stiffness of the pulmonary arteries (PAs) may also be increased in COPD and emphysema, but data are lacking. We assessed PA stiffness using MRI in patients with COPD and related these measurements to COPD severity and percent emphysema. MATERIALS AND METHODS: The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study recruited 290 participants, age 50-79 years with 10 or more packyears and free of clinical cardiovascular disease. COPD severity were defined on postbronchodilator spirometry by ATS/ERS criteria. Percent emphysema was defined as the percentage of regions of the lung < -950 Hounsfield units on full-lung computed tomography (CT). PA stain was defined by the percent change in cross-sectional PA area between systole and diastole on MRI. Blood flow across the tricuspid and mitral valves was assessed by phase-contrast MRI for determination of the ventricular diastolic dysfunction (E/A ratio). RESULTS:PA strain was reduced in COPD compared with controls (P = 0.002) and was inversely correlated with COPD severity (P = 0.004). PA strain was inversely associated to percent emphysema (P = 0.01). PA strain was also markedly correlated with right ventricular diastolic dysfunction measured by E/A ratios in the fully adjusted mix models (P = 0.02). CONCLUSION:PA strain is reduced in COPD, related in part to percent emphysema on CT scan, which may have implications for pulmonary small vessel flow and right ventricular function. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:262-271.
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