TY - JOUR
T1 - The relationship between small pulmonary vascular alteration and aortic atherosclerosis in chronic obstructive pulmonary disease. Quantitative CT analysis
AU - Matsuoka, Shin
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 J.
AU - Hatabu, Hiroto
AU - Washko, George R.
N1 - Funding Information:
Supported by National Institutes of Health (Grants K23HL089353-01A1, U01 HL089856-0 ), and a grant from The Parker B. Francis Foundation .
PY - 2011/1
Y1 - 2011/1
N2 - 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.
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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U2 - 10.1016/j.acra.2010.08.013
DO - 10.1016/j.acra.2010.08.013
M3 - Article
C2 - 20947389
AN - SCOPUS:78649906799
SN - 1076-6332
VL - 18
SP - 40
EP - 46
JO - Academic radiology
JF - Academic radiology
IS - 1
ER -