Marta Marin-Oto1, Luis M Seijo2, Miguel Divo3, Gorka Bastarrika4, Ana Ezponda4, Marta Calvo4, Javier J Zulueta1, Guillermo Gallardo5, Elena Cabezas5, German Peces-Barba5, Maria T Pérez-Warnisher2, Jose M Marín6, Bartolomé R Celli3, Ciro Casanova7, Juan P De-Torres8. 1. Department of Respiratory Medicine, Clínica Universidad de Navarra, University of Navarra, Avenida Pío XII, 36, 31008 Pamplona, Spain. 2. Department of Respiratory Medicine, Clínica Universidad de Navarra, University of Navarra, Calle Marquesado de Sta. Marta, 1, 28027 Madrid, Spain. 3. Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115, USA. 4. Department of Radiology, Clínica Universidad de Navarra, University of Navarra, Avenida Pío XII, 36, 31008 Pamplona, Spain. 5. Department of Respiratory Medicine, Fundación Jiménez-Díaz, Av. de los Reyes Católicos, 2, 28040 Madrid, Spain. 6. Department of Respiratory Medicine, Hospital Universitario Miguel Servet, University of Zaragoza, Av. Isabel la Católica 3, 50009 Zaragoza, Spain. 7. Department of Respiratory Medicine, Hospital Nuestra Señora de la Candelaria, Ctra. Gral. del Rosario, 145, 38010 Santa Cruz de Tenerife, Spain. 8. Pulmonary Division, Kingston General Hospital, Queen's University, 76 Stuart St., Kingston, ON K7L 2V7, Canada.
Abstract
BACKGROUND: Pulmonary artery enlargement (PAE) detected using chest computed tomography (CT) is associated with poor outcomes in chronic obstructive pulmonary disease (COPD). It is unknown whether nocturnal hypoxemia occurring in smokers, with or without COPD, obstructive sleep apnoea (OSA) or their overlap, may be associated with PAE assessed by chest CT. METHODS: We analysed data from two prospective cohort studies that enrolled 284 smokers in lung cancer screening programs and completing baseline home sleep studies and chest CT scans. Main pulmonary artery diameter (PAD) and the ratio of the PAD to that of the aorta (PA:Ao ratio) were measured. PAE was defined as a PAD ≥ 29 mm in men and ≥27 mm in women or as a PA:Ao ratio > 0.9. We evaluated the association of PAE with baseline characteristics using multivariate logistic models. RESULTS: PAE prevalence was 27% as defined by PAD measurements and 11.6% by the PA:Ao ratio. A body mass index ≥ 30 kg/m2 (OR 2.01; 95%CI 1.06-3.78), lower % predicted of forced expiratory volume in one second (FEV1) (OR 1.03; 95%CI 1.02-1.05) and higher % of sleep time with O2 saturation < 90% (T90) (OR 1.02; 95%CI 1.00-1.03), were associated with PAE as determined by PAD. However, only T90 remained significantly associated with PAE as defined by the PA:Ao ratio (OR 1.02; 95%CI 1.01-1.03). In the subset group without OSA, only T90 remains associated with PAE, whether defined by PAD measurement (OR 1.02; 95%CI 1.01-1.03) or PA:Ao ratio (OR 1.04; 95%CI 1.01-1.07). CONCLUSIONS: In smokers with or without COPD, nocturnal hypoxemia was associated with PAE independently of OSA coexistence.
BACKGROUND:Pulmonary artery enlargement (PAE) detected using chest computed tomography (CT) is associated with poor outcomes in chronic obstructive pulmonary disease (COPD). It is unknown whether nocturnal hypoxemia occurring in smokers, with or without COPD, obstructive sleep apnoea (OSA) or their overlap, may be associated with PAE assessed by chest CT. METHODS: We analysed data from two prospective cohort studies that enrolled 284 smokers in lung cancer screening programs and completing baseline home sleep studies and chest CT scans. Main pulmonary artery diameter (PAD) and the ratio of the PAD to that of the aorta (PA:Ao ratio) were measured. PAE was defined as a PAD ≥ 29 mm in men and ≥27 mm in women or as a PA:Ao ratio > 0.9. We evaluated the association of PAE with baseline characteristics using multivariate logistic models. RESULTS:PAE prevalence was 27% as defined by PAD measurements and 11.6% by the PA:Ao ratio. A body mass index ≥ 30 kg/m2 (OR 2.01; 95%CI 1.06-3.78), lower % predicted of forced expiratory volume in one second (FEV1) (OR 1.03; 95%CI 1.02-1.05) and higher % of sleep time with O2 saturation < 90% (T90) (OR 1.02; 95%CI 1.00-1.03), were associated with PAE as determined by PAD. However, only T90 remained significantly associated with PAE as defined by the PA:Ao ratio (OR 1.02; 95%CI 1.01-1.03). In the subset group without OSA, only T90 remains associated with PAE, whether defined by PAD measurement (OR 1.02; 95%CI 1.01-1.03) or PA:Ao ratio (OR 1.04; 95%CI 1.01-1.07). CONCLUSIONS: In smokers with or without COPD, nocturnal hypoxemia was associated with PAE independently of OSA coexistence.
Authors: M R Miller; J Hankinson; V Brusasco; F Burgos; R Casaburi; A Coates; R Crapo; P Enright; C P M van der Grinten; P Gustafsson; R Jensen; D C Johnson; N MacIntyre; R McKay; D Navajas; O F Pedersen; R Pellegrino; G Viegi; J Wanger Journal: Eur Respir J Date: 2005-08 Impact factor: 16.671
Authors: Miguel A Arias; Francisco García-Río; Alberto Alonso-Fernández; Isabel Martínez; José Villamor Journal: Eur Heart J Date: 2006-02-23 Impact factor: 29.983
Authors: Javier Sevilla-Montero; David Labrousse-Arias; Cintia Fernández-Pérez; Laura Fernández-Blanco; Bianca Barreira; Gema Mondéjar-Parreño; Elvira Alfaro-Arnedo; Icíar P López; Sandra Pérez-Rial; Germán Peces-Barba; José G Pichel; Víctor Ivo Peinado; Ángel Cogolludo; María J Calzada Journal: Am J Respir Crit Care Med Date: 2021-05-15 Impact factor: 21.405
Authors: Yves Lacasse; Frédéric Sériès; François Corbeil; Marc Baltzan; Bruno Paradis; Paula Simão; Araceli Abad Fernández; Cristóbal Esteban; Miguel Guimarães; Jean Bourbeau; Shawn D Aaron; Sarah Bernard; François Maltais Journal: N Engl J Med Date: 2020-09-17 Impact factor: 91.245
Authors: Denise R Aberle; Amanda M Adams; Christine D Berg; Jonathan D Clapp; Kathy L Clingan; Ilana F Gareen; David A Lynch; Pamela M Marcus; Paul F Pinsky Journal: J Natl Cancer Inst Date: 2010-11-22 Impact factor: 13.506
Authors: Tetyana Kendzerska; Richard S Leung; Shawn D Aaron; Najib Ayas; Jacqueline S Sandoz; Andrea S Gershon Journal: Ann Am Thorac Soc Date: 2019-01
Authors: Steven D Nathan; Joan A Barbera; Sean P Gaine; Sergio Harari; Fernando J Martinez; Horst Olschewski; Karen M Olsson; Andrew J Peacock; Joanna Pepke-Zaba; Steeve Provencher; Norbert Weissmann; Werner Seeger Journal: Eur Respir J Date: 2019-01-24 Impact factor: 16.671