Alkhanfar, D., Shahin, Y. orcid.org/0000-0001-7425-7798, Alandejani, F. et al. (13 more authors) (2022) Severe pulmonary hypertension associated with lung disease is characterised by a loss of small pulmonary vessels on quantitative CT. ERJ Open Research, 8 (2). 00503-2021. ISSN 2312-0541
Abstract
Background
Pulmonary hypertension (PH) in patients with chronic lung disease (CLD) predicts reduced functional status, clinical worsening and increased mortality, with patients with severe PHCLD (≥35mmHg) having a significantly worse prognosis than mild to moderate PH-CLD (21- 34mmHg). The aim of this cross-sectional study was to assess the association between computed tomography (CT) derived quantitative pulmonary vessel volume, PH severity and disease aetiology in CLD.
Methods
Treatment naïve patients with CLD who underwent CT pulmonary angiography, lung function testing and right heart catheterisation were identified from the ASPIRE Registry between October 2012 and July 2018. Quantitative assessments of total pulmonary vessel and small pulmonary vessel volume were performed.
Results
Ninety patients had PH-CLD including 44 associated with COPD/emphysema and 46 with interstitial lung disease. Patients with severe PH-CLD (n=40) had lower small pulmonary vessel volume compared to patients with mild to moderate PH-CLD (n=50). Patients with PH-ILD had significantly reduced small pulmonary blood vessel volume, compared to PHCOPD/emphysema. Higher mortality was identified in patients with lower small pulmonary vessel volume.
Conclusion
Patients with severe PH-CLD, regardless of aetiology, have lower small pulmonary vessel volume compared to patients with mild-moderate PH-CLD and this is associated with a higher mortality. Whether pulmonary vessel changes quantified by CT are a marker of remodelling of the distal pulmonary vasculature requires further study.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The authors 2022. This version is distributed under the terms of the Creative Commons Attribution Licence 4.0. (http://creativecommons.org/licenses/by/4.0) |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Sheffield Teaching Hospitals |
Funding Information: | Funder Grant number WELLCOME TRUST (THE) 205188/Z/16/Z WELLCOME TRUST (THE) 206632/Z/17/Z BRITISH HEART FOUNDATION FS/18/13/33281 |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 12 May 2022 11:43 |
Last Modified: | 27 May 2022 11:40 |
Status: | Published |
Publisher: | European Respiratory Society |
Refereed: | Yes |
Identification Number: | 10.1183/23120541.00503-2021 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:186764 |