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Severe pulmonary hypertension associated with lung disease is characterised by a loss of small pulmonary vessels on quantitative computed tomography

BACKGROUND: Pulmonary hypertension (PH) in patients with chronic lung disease (CLD) predicts reduced functional status, clinical worsening and increased mortality, with patients with severe PH-CLD (≥35 mmHg) having a significantly worse prognosis than mild to moderate PH-CLD (21–34 mmHg). The aim of...

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Autores principales: Alkhanfar, Dheyaa, Shahin, Yousef, Alandejani, Faisal, Dwivedi, Krit, Alabed, Samer, Johns, Chris, Lawrie, Allan, Thompson, A.A. Roger, Rothman, Alexander M.K., Tschirren, Juerg, Uthoff, Johanna M., Hoffman, Eric, Condliffe, Robin, Wild, Jim M., Kiely, David G., Swift, Andrew J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Respiratory Society 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9108962/
https://www.ncbi.nlm.nih.gov/pubmed/35586449
http://dx.doi.org/10.1183/23120541.00503-2021
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author Alkhanfar, Dheyaa
Shahin, Yousef
Alandejani, Faisal
Dwivedi, Krit
Alabed, Samer
Johns, Chris
Lawrie, Allan
Thompson, A.A. Roger
Rothman, Alexander M.K.
Tschirren, Juerg
Uthoff, Johanna M.
Hoffman, Eric
Condliffe, Robin
Wild, Jim M.
Kiely, David G.
Swift, Andrew J.
author_facet Alkhanfar, Dheyaa
Shahin, Yousef
Alandejani, Faisal
Dwivedi, Krit
Alabed, Samer
Johns, Chris
Lawrie, Allan
Thompson, A.A. Roger
Rothman, Alexander M.K.
Tschirren, Juerg
Uthoff, Johanna M.
Hoffman, Eric
Condliffe, Robin
Wild, Jim M.
Kiely, David G.
Swift, Andrew J.
author_sort Alkhanfar, Dheyaa
collection PubMed
description BACKGROUND: Pulmonary hypertension (PH) in patients with chronic lung disease (CLD) predicts reduced functional status, clinical worsening and increased mortality, with patients with severe PH-CLD (≥35 mmHg) having a significantly worse prognosis than mild to moderate PH-CLD (21–34 mmHg). 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: 90 patients had PH-CLD including 44 associated with COPD/emphysema and 46 with interstitial lung disease (ILD). 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 PH-COPD/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.
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spelling pubmed-91089622022-05-17 Severe pulmonary hypertension associated with lung disease is characterised by a loss of small pulmonary vessels on quantitative computed tomography Alkhanfar, Dheyaa Shahin, Yousef Alandejani, Faisal Dwivedi, Krit Alabed, Samer Johns, Chris Lawrie, Allan Thompson, A.A. Roger Rothman, Alexander M.K. Tschirren, Juerg Uthoff, Johanna M. Hoffman, Eric Condliffe, Robin Wild, Jim M. Kiely, David G. Swift, Andrew J. ERJ Open Res Original Research Articles BACKGROUND: Pulmonary hypertension (PH) in patients with chronic lung disease (CLD) predicts reduced functional status, clinical worsening and increased mortality, with patients with severe PH-CLD (≥35 mmHg) having a significantly worse prognosis than mild to moderate PH-CLD (21–34 mmHg). 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: 90 patients had PH-CLD including 44 associated with COPD/emphysema and 46 with interstitial lung disease (ILD). 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 PH-COPD/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. European Respiratory Society 2022-05-16 /pmc/articles/PMC9108962/ /pubmed/35586449 http://dx.doi.org/10.1183/23120541.00503-2021 Text en Copyright ©The authors 2022 https://creativecommons.org/licenses/by/4.0/This version is distributed under the terms of the Creative Commons Attribution Licence 4.0.
spellingShingle Original Research Articles
Alkhanfar, Dheyaa
Shahin, Yousef
Alandejani, Faisal
Dwivedi, Krit
Alabed, Samer
Johns, Chris
Lawrie, Allan
Thompson, A.A. Roger
Rothman, Alexander M.K.
Tschirren, Juerg
Uthoff, Johanna M.
Hoffman, Eric
Condliffe, Robin
Wild, Jim M.
Kiely, David G.
Swift, Andrew J.
Severe pulmonary hypertension associated with lung disease is characterised by a loss of small pulmonary vessels on quantitative computed tomography
title Severe pulmonary hypertension associated with lung disease is characterised by a loss of small pulmonary vessels on quantitative computed tomography
title_full Severe pulmonary hypertension associated with lung disease is characterised by a loss of small pulmonary vessels on quantitative computed tomography
title_fullStr Severe pulmonary hypertension associated with lung disease is characterised by a loss of small pulmonary vessels on quantitative computed tomography
title_full_unstemmed Severe pulmonary hypertension associated with lung disease is characterised by a loss of small pulmonary vessels on quantitative computed tomography
title_short Severe pulmonary hypertension associated with lung disease is characterised by a loss of small pulmonary vessels on quantitative computed tomography
title_sort severe pulmonary hypertension associated with lung disease is characterised by a loss of small pulmonary vessels on quantitative computed tomography
topic Original Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9108962/
https://www.ncbi.nlm.nih.gov/pubmed/35586449
http://dx.doi.org/10.1183/23120541.00503-2021
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