title: Pulmonary Artery Abnormalities in Ex-smokers with and without Airflow Obstruction.
abstract: Pulmonary vascular disease is a common complication of chronic obstructive pulmonary disease (COPD), and an important risk factor for COPD exacerbations and death. We explored the relationship between pulmonary artery volumes measured using thoracic computed tomography (CT) and lung structure-function measured using spirometry, CT and magnetic resonance imaging (MRI) in 124 ex-smokers with (n = 68) and without (n = 56) airflow obstruction, and a control group of 35 never-smokers. We observed significantly greater main (p = .01), right (p = .001) and total (p = .003) pulmonary artery volumes in ex-smokers with airflow obstruction as compared to ex-smokers without airflow obstruction. There were also significantly greater pulmonary artery volumes in both ex-smoker subgroups, compared to the never-smoker subgroup (p = .008). For all participants, there were significant correlations for pulmonary artery volumes with the ratio of the forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC), the diffusing capacity of the lung for carbon monoxide (DLCO%pred), airway count, MRI ventilation defect percent and MRI apparent diffusion coefficients. In ex-smokers, ventilation defect percent was significantly correlated with right (r = 0.27, p = .02) and total (r = 0.25, p = .03) pulmonary artery volumes. Multivariate zero-inflated Poisson regression analysis showed that FEV1%pred (p = .004), DLCO%pred (p = .03), the six minute walk distance (p = .04) and total pulmonary artery volume (p = .03) were significant predictors of acute exacerbations of COPD, while the number of previous exacerbations was not. In conclusion, pulmonary artery enlargement measured using thoracic CT was observed even in ex-smokers without airflow obstruction and was predictive of COPD exacerbations in ex-smokers with airflow obstruction.
authors.affiliation: a 1 Robarts Research Institute , London , Ontario , Canada.|b 2 Department of Medical Biophysics , Western University , London , Ontario , Canada.
authors.forename: Tamas J
authors.initials: TJ
authors.lastname: Lindenmaier
authors.affiliation: c 3 Centre for Heart Lung Innovation, St Paul's Hospital , University of British Columbia , Vancouver , Canada.
authors.forename: Miranda
authors.initials: M
authors.lastname: Kirby
authors.affiliation: a 1 Robarts Research Institute , London , Ontario , Canada.|b 2 Department of Medical Biophysics , Western University , London , Ontario , Canada.
authors.forename: Gregory
authors.initials: G
authors.lastname: Paulin
authors.affiliation: d 4 Division of Cardiology , University of Ottawa, Ottawa Heart Institute , Ottawa , Canada.
authors.forename: Lisa
authors.initials: L
authors.lastname: Mielniczuk
authors.affiliation: a 1 Robarts Research Institute , London , Ontario , Canada.|b 2 Department of Medical Biophysics , Western University , London , Ontario , Canada.
authors.forename: Ian A
authors.initials: IA
authors.lastname: Cunningham
authors.affiliation: e 5 Division of Respirology, Department of Medicine , Western University , London , Ontario , Canada.
authors.forename: Marco
authors.initials: M
authors.lastname: Mura
authors.affiliation: e 5 Division of Respirology, Department of Medicine , Western University , London , Ontario , Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Licskai
authors.affiliation: a 1 Robarts Research Institute , London , Ontario , Canada.|b 2 Department of Medical Biophysics , Western University , London , Ontario , Canada.
authors.forename: Grace
authors.initials: G
authors.lastname: Parraga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010991:Plethysmography; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D012907:Smoking / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D054079:Vascular Malformations / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D014797:Vital Capacity
keywords: COPD; airflow obstruction; airways disease; emphysema; exacerbations; pulmonary artery enlargement