title: T1 measurements for detection of expansion of the myocardial extracellular volume in chronic obstructive pulmonary disease.
abstract: BACKGROUND
  We aimed to assess whether chronic obstructive pulmonary disease (COPD) is associated with expansion of the myocardial extracellular volume (ECV) using T1 measurements.
  
  
  METHODS
  Adult COPD patients Global Initiative for Chronic Obstructive Lung Disease [GOLD] stage 2 or higher and free of known cardiovascular disease were recruited. All study patients underwent measures of pulmonary function, 6-minute walk test, serum measures of inflammation, overnight polysomnography, and a contrast cardiac magnetic resonance study.
  
  
  RESULTS
  Eight patients with COPD were compared with 8 healthy control subjects. The mean predicted forced expiratory volume at 1 second of COPD subjects was 68%. Compared with control subjects, patients had normal left ventricular (LV) and right ventricular size, mass, and function. However, compared with control subjects, the LV remodelling index (median, 0.87; interquartile range [IQR], 0.71-1.14; vs median, 0.62; IQR, 0.60-0.77; P ¼ 0.03) and active left atrial emptying fraction was increased (median, 46; IQR, 41-49; vs median, 38; IQR, 33-43; P ¼ 0.005), and passive left atrial emptying fraction was reduced (median, 24; IQR, 20-30; vs median, 44; IQR, 31-51; P ¼ 0.007). The ECV was increased in patients with COPD (median, 0.32; IQR, 0.05; vs median, 0.27; IQR, 0.05; P = 0.001). The ECV showed a strong positive association with LV remodelling (r = 0.72; P = 0.04) and an inverse association with the 6-minute walk duration (r = -0.79; P = 0.02) and passive left atrial emptying fraction (r = -0.68; P = 0.003).
  
  
  CONCLUSIONS
  Expansion of the ECV, suggestive of diffuse myocardial fibrosis, is present in COPD and is associated with LV remodelling, and reduced left atrial function and exercise capacity.
authors.affiliation: Division of Cardiology, Department of Medicine, Massachusetts General Hospital; Cardiac MR PET CT Program, Division of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Tomas G
authors.initials: TG
authors.lastname: Neilan
authors.affiliation: Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. Electronic address: jpbakker@partners.org.
authors.forename: Jessie P
authors.initials: JP
authors.lastname: Bakker
authors.affiliation: Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Bhavneesh
authors.initials: B
authors.lastname: Sharma
authors.affiliation: Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Owens
authors.affiliation: Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Hoshang
authors.initials: H
authors.lastname: Farhad
authors.affiliation: Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Ravi V
authors.initials: RV
authors.lastname: Shah
authors.affiliation: Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Siddique A
authors.initials: SA
authors.lastname: Abbasi
authors.affiliation: Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Puja
authors.initials: P
authors.lastname: Kohli
authors.affiliation: Division of Cardiovascular Medicine, University of California San Diego, San Diego, California, USA.
authors.forename: Joel
authors.initials: J
authors.lastname: Wilson
authors.affiliation: Division of Cardiovascular Medicine, University of California San Diego, San Diego, California, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: DeMaria
authors.affiliation: Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Jerosch-Herold
authors.affiliation: Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Raymond Y
authors.initials: RY
authors.lastname: Kwong
authors.affiliation: Pulmonary and Critical Care Division, University of California San Diego, San Diego, California, USA.
authors.forename: Atul
authors.initials: A
authors.lastname: Malhotra
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D012189:Retrospective Studies; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling / Q000502:physiology*