Pulmonary hyperinflation due to gas trapping and pulmonary artery size: The MESA COPD Study. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Pulmonary hypertension is associated with increased morbidity and mortality in chronic obstructive pulmonary disease (COPD). Since pulmonary artery (PA) size increases in pulmonary hypertension, we measured PA cross-sectional area using magnetic resonance imaging (MRI) to test the hypothesis that pulmonary hyperinflation due to gas trapping is associated with PA cross-sectional area in COPD. METHODS: The MESA COPD Study recruited participants with COPD and controls from two population-based cohort studies ages 50-79 years with 10 or more pack-years and free of clinical cardiovascular disease. Body plethysmography was performed according to standard criteria. Cardiac MRI was performed at functional residual capacity to measure the cross-sectional area of the main PA. Percent emphysema was defined as the percentage of lung voxels less than -950 Hounsfield units as assessed via x-ray computed tomography. Analyses were adjusted for age, gender, height, weight, race-ethnicity, the forced expiratory volume in one second, smoking status, pack-years, lung function, oxygen saturation, blood pressure, left ventricular ejection fraction and percent emphysema. RESULTS: Among 106 participants, mean residual volume was 1.98±0.71 L and the mean PA cross-sectional area was 7.23±1.72 cm2. A one standard deviation increase in residual volume was independently associated with an increase in main PA cross-sectional area of 0.55 cm2 (95% CI 0.18 to 0.92; p = 0.003). In contrast, there was no evidence for an association with percent emphysema or total lung capacity. CONCLUSION: Increased residual volume was associated with a larger PA in COPD, suggesting that gas trapping may contribute to pulmonary hypertension in COPD.

publication date

  • May 2, 2017

Research

keywords

  • Hypertension, Pulmonary
  • Pulmonary Artery
  • Pulmonary Disease, Chronic Obstructive

Identity

PubMed Central ID

  • PMC5413010

Scopus Document Identifier

  • 85018961252

Digital Object Identifier (DOI)

  • 10.1378/chest.13-0183

PubMed ID

  • 28463971

Additional Document Info

volume

  • 12

issue

  • 5