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Vascular remodeling of the small pulmonary arteries and measures of vascular pruning on computed tomography
Pulmonary hypertension is characterized histologically by intimal and medial thickening in the small pulmonary arteries, eventually resulting in vascular “pruning.” Computed tomography (CT)-based quantification of pruning is associated with clinical measures of pulmonary hypertension, but it is not...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8647266/ https://www.ncbi.nlm.nih.gov/pubmed/34881020 http://dx.doi.org/10.1177/20458940211061284 |
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author | Synn, Andrew J. Margerie-Mellon, Constance De Jeong, Sun Young Rahaghi, Farbod N. Jhun, Iny Washko, George R. Estépar, Raúl San José Bankier, Alexander A. Mittleman, Murray A. VanderLaan, Paul A. Rice, Mary B. |
author_facet | Synn, Andrew J. Margerie-Mellon, Constance De Jeong, Sun Young Rahaghi, Farbod N. Jhun, Iny Washko, George R. Estépar, Raúl San José Bankier, Alexander A. Mittleman, Murray A. VanderLaan, Paul A. Rice, Mary B. |
author_sort | Synn, Andrew J. |
collection | PubMed |
description | Pulmonary hypertension is characterized histologically by intimal and medial thickening in the small pulmonary arteries, eventually resulting in vascular “pruning.” Computed tomography (CT)-based quantification of pruning is associated with clinical measures of pulmonary hypertension, but it is not established whether CT-based pruning correlates with histologic arterial remodeling. Our sample consisted of 138 patients who underwent resection for early-stage lung adenocarcinoma. From histologic sections, we identified small pulmonary arteries and measured the relative area comprising the intima and media (VWA%), with higher VWA% representing greater histologic remodeling. From pre-operative CTs, we used image analysis algorithms to calculate the small vessel volume fraction (BV5/TBV) as a CT-based indicator of pruning (lower BV5/TBV represents greater pruning). We investigated relationships of CT pruning and histologic remodeling using Pearson correlation, simple linear regression, and multivariable regression with adjustment for age, sex, height, weight, smoking status, and total pack-years. We also tested for effect modification by sex and smoking status. In primary models, more severe CT pruning was associated with greater histologic remodeling. The Pearson correlation coefficient between BV5/TBV and VWA% was –0.41, and in linear regression models, VWA% was 3.13% higher (95% CI: 1.95–4.31%, p < 0.0001) per standard deviation lower BV5/TBV. This association persisted after multivariable adjustment. We found no evidence that these relationships differed by sex or smoking status. Among individuals who underwent resection for lung adenocarcinoma, more severe CT-based vascular pruning was associated with greater histologic arterial remodeling. These findings suggest CT imaging may be a non-invasive indicator of pulmonary vascular pathology. |
format | Online Article Text |
id | pubmed-8647266 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-86472662021-12-07 Vascular remodeling of the small pulmonary arteries and measures of vascular pruning on computed tomography Synn, Andrew J. Margerie-Mellon, Constance De Jeong, Sun Young Rahaghi, Farbod N. Jhun, Iny Washko, George R. Estépar, Raúl San José Bankier, Alexander A. Mittleman, Murray A. VanderLaan, Paul A. Rice, Mary B. Pulm Circ Original Research Article Pulmonary hypertension is characterized histologically by intimal and medial thickening in the small pulmonary arteries, eventually resulting in vascular “pruning.” Computed tomography (CT)-based quantification of pruning is associated with clinical measures of pulmonary hypertension, but it is not established whether CT-based pruning correlates with histologic arterial remodeling. Our sample consisted of 138 patients who underwent resection for early-stage lung adenocarcinoma. From histologic sections, we identified small pulmonary arteries and measured the relative area comprising the intima and media (VWA%), with higher VWA% representing greater histologic remodeling. From pre-operative CTs, we used image analysis algorithms to calculate the small vessel volume fraction (BV5/TBV) as a CT-based indicator of pruning (lower BV5/TBV represents greater pruning). We investigated relationships of CT pruning and histologic remodeling using Pearson correlation, simple linear regression, and multivariable regression with adjustment for age, sex, height, weight, smoking status, and total pack-years. We also tested for effect modification by sex and smoking status. In primary models, more severe CT pruning was associated with greater histologic remodeling. The Pearson correlation coefficient between BV5/TBV and VWA% was –0.41, and in linear regression models, VWA% was 3.13% higher (95% CI: 1.95–4.31%, p < 0.0001) per standard deviation lower BV5/TBV. This association persisted after multivariable adjustment. We found no evidence that these relationships differed by sex or smoking status. Among individuals who underwent resection for lung adenocarcinoma, more severe CT-based vascular pruning was associated with greater histologic arterial remodeling. These findings suggest CT imaging may be a non-invasive indicator of pulmonary vascular pathology. SAGE Publications 2021-11-29 /pmc/articles/PMC8647266/ /pubmed/34881020 http://dx.doi.org/10.1177/20458940211061284 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Article Synn, Andrew J. Margerie-Mellon, Constance De Jeong, Sun Young Rahaghi, Farbod N. Jhun, Iny Washko, George R. Estépar, Raúl San José Bankier, Alexander A. Mittleman, Murray A. VanderLaan, Paul A. Rice, Mary B. Vascular remodeling of the small pulmonary arteries and measures of vascular pruning on computed tomography |
title | Vascular remodeling of the small pulmonary arteries and measures of
vascular pruning on computed tomography |
title_full | Vascular remodeling of the small pulmonary arteries and measures of
vascular pruning on computed tomography |
title_fullStr | Vascular remodeling of the small pulmonary arteries and measures of
vascular pruning on computed tomography |
title_full_unstemmed | Vascular remodeling of the small pulmonary arteries and measures of
vascular pruning on computed tomography |
title_short | Vascular remodeling of the small pulmonary arteries and measures of
vascular pruning on computed tomography |
title_sort | vascular remodeling of the small pulmonary arteries and measures of
vascular pruning on computed tomography |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8647266/ https://www.ncbi.nlm.nih.gov/pubmed/34881020 http://dx.doi.org/10.1177/20458940211061284 |
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