The relationship between small pulmonary vascular alteration and aortic atherosclerosis in chronic obstructive pulmonary disease. Quantitative CT analysis

Shin Matsuoka, Tsuneo Yamashiro, Alejandro Diaz, Raúl San José Estépar, James C. Ross, Edwin K. Silverman, Yasuyuki Kobayashi, Mark T. Dransfield, Brian Jack Bartholmai, Hiroto Hatabu, George R. Washko

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Rationale and Objectives: The relationship between chronic obstructive pulmonary disease (COPD) and atherosclerosis has been suggested; this association may relate to systemic inflammation and endothelial dysfunction, which can lead to alteration of small pulmonary vessels. The relationship between atherosclerosis and small pulmonary vessel alteration, however, has not been assessed in COPD patients. We tested the hypothesis that the severity of thoracic aortic calcification measured by computed tomography (CT) would be associated with the total cross-sectional area of small pulmonary vessels (CSA) on CT images. Materials and Methods: The study was approved by the institutional review board and was Health Insurance Portability and Accountability Act-compliant. Informed consent was waived. For 51 COPD patients enrolled in the National Heart, Lung, and Blood Institute Lung Tissue Research Consortium, we calculated the percentage of total CSAs of less than 5 mm2 for the total lung area (%CSA<5). Thoracic aortic calcification, quantified by modified Agatston score, was measured. The correlations between thoracic aortic calcification score and %CSA<5, pulmonary function, and extent of emphysema were evaluated. Multiple linear regression analysis using aortic calcification score as the dependent outcome was also performed. Results: The %CSA<5 had a significant negative correlation with the thoracic aortic calcification score (r = -0.566, P < .0001). Multiple linear regression analysis showed significant correlation between the aortic calcification score and %CSA<5 (P < .0001) independent of age, pack-years, extent of emphysema, and FEV1%. Conclusions: Atherosclerosis, assessed by aortic calcification, is associated with the small pulmonary vascular alteration in COPD. Systemic inflammation and endothelial dysfunction may cause the close relationship between atherosclerosis and small pulmonary vessel alteration.

Original languageEnglish (US)
Pages (from-to)40-46
Number of pages7
JournalAcademic Radiology
Volume18
Issue number1
DOIs
StatePublished - Jan 2011

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Chronic Obstructive Pulmonary Disease
Blood Vessels
Atherosclerosis
Tomography
Lung
Thorax
Emphysema
Linear Models
Regression Analysis
Inflammation
Health Insurance Portability and Accountability Act
National Heart, Lung, and Blood Institute (U.S.)
Research Ethics Committees
Informed Consent
Research

Keywords

  • Atherosclerosis
  • Chronic obstructive
  • Computed tomography
  • Pulmonary artery
  • Systemic inflammation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

The relationship between small pulmonary vascular alteration and aortic atherosclerosis in chronic obstructive pulmonary disease. Quantitative CT analysis. / Matsuoka, Shin; Yamashiro, Tsuneo; Diaz, Alejandro; San José Estépar, Raúl; Ross, James C.; Silverman, Edwin K.; Kobayashi, Yasuyuki; Dransfield, Mark T.; Bartholmai, Brian Jack; Hatabu, Hiroto; Washko, George R.

In: Academic Radiology, Vol. 18, No. 1, 01.2011, p. 40-46.

Research output: Contribution to journalArticle

Matsuoka, S, Yamashiro, T, Diaz, A, San José Estépar, R, Ross, JC, Silverman, EK, Kobayashi, Y, Dransfield, MT, Bartholmai, BJ, Hatabu, H & Washko, GR 2011, 'The relationship between small pulmonary vascular alteration and aortic atherosclerosis in chronic obstructive pulmonary disease. Quantitative CT analysis', Academic Radiology, vol. 18, no. 1, pp. 40-46. https://doi.org/10.1016/j.acra.2010.08.013
Matsuoka, Shin ; Yamashiro, Tsuneo ; Diaz, Alejandro ; San José Estépar, Raúl ; Ross, James C. ; Silverman, Edwin K. ; Kobayashi, Yasuyuki ; Dransfield, Mark T. ; Bartholmai, Brian Jack ; Hatabu, Hiroto ; Washko, George R. / The relationship between small pulmonary vascular alteration and aortic atherosclerosis in chronic obstructive pulmonary disease. Quantitative CT analysis. In: Academic Radiology. 2011 ; Vol. 18, No. 1. pp. 40-46.
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abstract = "Rationale and Objectives: The relationship between chronic obstructive pulmonary disease (COPD) and atherosclerosis has been suggested; this association may relate to systemic inflammation and endothelial dysfunction, which can lead to alteration of small pulmonary vessels. The relationship between atherosclerosis and small pulmonary vessel alteration, however, has not been assessed in COPD patients. We tested the hypothesis that the severity of thoracic aortic calcification measured by computed tomography (CT) would be associated with the total cross-sectional area of small pulmonary vessels (CSA) on CT images. Materials and Methods: The study was approved by the institutional review board and was Health Insurance Portability and Accountability Act-compliant. Informed consent was waived. For 51 COPD patients enrolled in the National Heart, Lung, and Blood Institute Lung Tissue Research Consortium, we calculated the percentage of total CSAs of less than 5 mm2 for the total lung area ({\%}CSA<5). Thoracic aortic calcification, quantified by modified Agatston score, was measured. The correlations between thoracic aortic calcification score and {\%}CSA<5, pulmonary function, and extent of emphysema were evaluated. Multiple linear regression analysis using aortic calcification score as the dependent outcome was also performed. Results: The {\%}CSA<5 had a significant negative correlation with the thoracic aortic calcification score (r = -0.566, P < .0001). Multiple linear regression analysis showed significant correlation between the aortic calcification score and {\%}CSA<5 (P < .0001) independent of age, pack-years, extent of emphysema, and FEV1{\%}. Conclusions: Atherosclerosis, assessed by aortic calcification, is associated with the small pulmonary vascular alteration in COPD. Systemic inflammation and endothelial dysfunction may cause the close relationship between atherosclerosis and small pulmonary vessel alteration.",
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AU - Yamashiro, Tsuneo

AU - Diaz, Alejandro

AU - San José Estépar, Raúl

AU - Ross, James C.

AU - Silverman, Edwin K.

AU - Kobayashi, Yasuyuki

AU - Dransfield, Mark T.

AU - Bartholmai, Brian Jack

AU - Hatabu, Hiroto

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AB - Rationale and Objectives: The relationship between chronic obstructive pulmonary disease (COPD) and atherosclerosis has been suggested; this association may relate to systemic inflammation and endothelial dysfunction, which can lead to alteration of small pulmonary vessels. The relationship between atherosclerosis and small pulmonary vessel alteration, however, has not been assessed in COPD patients. We tested the hypothesis that the severity of thoracic aortic calcification measured by computed tomography (CT) would be associated with the total cross-sectional area of small pulmonary vessels (CSA) on CT images. Materials and Methods: The study was approved by the institutional review board and was Health Insurance Portability and Accountability Act-compliant. Informed consent was waived. For 51 COPD patients enrolled in the National Heart, Lung, and Blood Institute Lung Tissue Research Consortium, we calculated the percentage of total CSAs of less than 5 mm2 for the total lung area (%CSA<5). Thoracic aortic calcification, quantified by modified Agatston score, was measured. The correlations between thoracic aortic calcification score and %CSA<5, pulmonary function, and extent of emphysema were evaluated. Multiple linear regression analysis using aortic calcification score as the dependent outcome was also performed. Results: The %CSA<5 had a significant negative correlation with the thoracic aortic calcification score (r = -0.566, P < .0001). Multiple linear regression analysis showed significant correlation between the aortic calcification score and %CSA<5 (P < .0001) independent of age, pack-years, extent of emphysema, and FEV1%. Conclusions: Atherosclerosis, assessed by aortic calcification, is associated with the small pulmonary vascular alteration in COPD. Systemic inflammation and endothelial dysfunction may cause the close relationship between atherosclerosis and small pulmonary vessel alteration.

KW - Atherosclerosis

KW - Chronic obstructive

KW - Computed tomography

KW - Pulmonary artery

KW - Systemic inflammation

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