RT Journal Article
SR Electronic
T1 Severe pulmonary hypertension associated with lung disease is characterised by a loss of small pulmonary vessels on quantitative computed tomography
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00503-2021
DO 10.1183/23120541.00503-2021
VO 8
IS 2
A1 Dheyaa Alkhanfar
A1 Yousef Shahin
A1 Faisal Alandejani
A1 Krit Dwivedi
A1 Samer Alabed
A1 Chris Johns
A1 Allan Lawrie
A1 A.A. Roger Thompson
A1 Alexander M.K. Rothman
A1 Juerg Tschirren
A1 Johanna M. Uthoff
A1 Eric Hoffman
A1 Robin Condliffe
A1 Jim M. Wild
A1 David G. Kiely
A1 Andrew J. Swift
YR 2022
UL http://openres.ersjournals.com/content/8/2/00503-2021.abstract
AB 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.In patients with pulmonary hypertension associated with lung disease, reduced small pulmonary vessel volume on quantitative CT imaging identifies patients with severe pulmonary hypertension https://bit.ly/35bbEDu