Morphological changes in small pulmonary vessels are associated with severe acute exacerbation in chronic obstructive pulmonary disease
Katsuhiro Yoshimura,1,2 Yuzo Suzuki,1,2 Tomohiro Uto,2 Jun Sato,2 Shiro Imokawa,2 Takafumi Suda1 1Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan; 2Department of Respiratory Medicine, Iwata City Hospital, Iwata, Japan Background: Pulmonar...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2016-06-01
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| Series: | International Journal of COPD |
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| Online Access: | https://www.dovepress.com/morphological-changes-in-small-pulmonary-vessels-are-associated-with-s-peer-reviewed-article-COPD |
| _version_ | 1818147119414902784 |
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| author | Yoshimura K Suzuki Y Uto T Sato J Imokawa S Suda T |
| author_facet | Yoshimura K Suzuki Y Uto T Sato J Imokawa S Suda T |
| author_sort | Yoshimura K |
| collection | DOAJ |
| description | Katsuhiro Yoshimura,1,2 Yuzo Suzuki,1,2 Tomohiro Uto,2 Jun Sato,2 Shiro Imokawa,2 Takafumi Suda1 1Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan; 2Department of Respiratory Medicine, Iwata City Hospital, Iwata, Japan Background: Pulmonary vascular remodeling is essential for understanding the pathogenesis of chronic obstructive pulmonary disease (COPD). The total cross-sectional area (CSA) of small pulmonary vessels has been reported to correlate with the pulmonary artery pressure, and this technique has enabled the assessment of pulmonary vascular involvements. We investigated the contribution of morphological alterations in the pulmonary vessels to severe acute exacerbation of COPD (AE-COPD).Methods: This study enrolled 81 patients with COPD and 28 non-COPD subjects as control and assessed the percentage of CSA (%CSA) less than 5 mm2 (%CSA<5) and %CSA in the range of 5–10 mm2 (%CSA5–10) on high-resolution computed tomography images.Results: Compared with the non-COPD subjects, the COPD patients had lower %CSA<5. %CSA<5 was positively correlated with airflow limitation and negatively correlated with the extent of emphysema. COPD patients with lower %CSA<5 showed significantly increased incidences of severe AE-COPD (Gray’s test; P=0.011). Furthermore, lower %CSA<5 was significantly associated with severe AE-COPD (hazard ratio, 2.668; 95% confidence interval, 1.225–5.636; P=0.010).Conclusion: %CSA<5 was associated with an increased risk of severe AE-COPD. The distal pruning of the small pulmonary vessels is a part of the risk associated with AE-COPD, and %CSA<5 might be a surrogate marker for predicting AE-COPD. Keywords: chronic obstructive pulmonary disease (COPD), acute exacerbation, pulmonary vessels, cross-sectional area (CSA), computed tomography |
| first_indexed | 2024-12-11T12:30:11Z |
| format | Article |
| id | doaj.art-354aff5f732d4b0aa2765f24d232e3ee |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-12-11T12:30:11Z |
| publishDate | 2016-06-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-354aff5f732d4b0aa2765f24d232e3ee2022-12-22T01:07:16ZengDove Medical PressInternational Journal of COPD1178-20052016-06-012016Issue 11435144527652Morphological changes in small pulmonary vessels are associated with severe acute exacerbation in chronic obstructive pulmonary diseaseYoshimura KSuzuki YUto TSato JImokawa SSuda TKatsuhiro Yoshimura,1,2 Yuzo Suzuki,1,2 Tomohiro Uto,2 Jun Sato,2 Shiro Imokawa,2 Takafumi Suda1 1Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan; 2Department of Respiratory Medicine, Iwata City Hospital, Iwata, Japan Background: Pulmonary vascular remodeling is essential for understanding the pathogenesis of chronic obstructive pulmonary disease (COPD). The total cross-sectional area (CSA) of small pulmonary vessels has been reported to correlate with the pulmonary artery pressure, and this technique has enabled the assessment of pulmonary vascular involvements. We investigated the contribution of morphological alterations in the pulmonary vessels to severe acute exacerbation of COPD (AE-COPD).Methods: This study enrolled 81 patients with COPD and 28 non-COPD subjects as control and assessed the percentage of CSA (%CSA) less than 5 mm2 (%CSA<5) and %CSA in the range of 5–10 mm2 (%CSA5–10) on high-resolution computed tomography images.Results: Compared with the non-COPD subjects, the COPD patients had lower %CSA<5. %CSA<5 was positively correlated with airflow limitation and negatively correlated with the extent of emphysema. COPD patients with lower %CSA<5 showed significantly increased incidences of severe AE-COPD (Gray’s test; P=0.011). Furthermore, lower %CSA<5 was significantly associated with severe AE-COPD (hazard ratio, 2.668; 95% confidence interval, 1.225–5.636; P=0.010).Conclusion: %CSA<5 was associated with an increased risk of severe AE-COPD. The distal pruning of the small pulmonary vessels is a part of the risk associated with AE-COPD, and %CSA<5 might be a surrogate marker for predicting AE-COPD. Keywords: chronic obstructive pulmonary disease (COPD), acute exacerbation, pulmonary vessels, cross-sectional area (CSA), computed tomographyhttps://www.dovepress.com/morphological-changes-in-small-pulmonary-vessels-are-associated-with-s-peer-reviewed-article-COPDchronic obstructive pulmonary disease (COPD)acute exacerbationpulmonary vesselscross sectional area (CSA)computed tomography |
| spellingShingle | Yoshimura K Suzuki Y Uto T Sato J Imokawa S Suda T Morphological changes in small pulmonary vessels are associated with severe acute exacerbation in chronic obstructive pulmonary disease International Journal of COPD chronic obstructive pulmonary disease (COPD) acute exacerbation pulmonary vessels cross sectional area (CSA) computed tomography |
| title | Morphological changes in small pulmonary vessels are associated with severe acute exacerbation in chronic obstructive pulmonary disease |
| title_full | Morphological changes in small pulmonary vessels are associated with severe acute exacerbation in chronic obstructive pulmonary disease |
| title_fullStr | Morphological changes in small pulmonary vessels are associated with severe acute exacerbation in chronic obstructive pulmonary disease |
| title_full_unstemmed | Morphological changes in small pulmonary vessels are associated with severe acute exacerbation in chronic obstructive pulmonary disease |
| title_short | Morphological changes in small pulmonary vessels are associated with severe acute exacerbation in chronic obstructive pulmonary disease |
| title_sort | morphological changes in small pulmonary vessels are associated with severe acute exacerbation in chronic obstructive pulmonary disease |
| topic | chronic obstructive pulmonary disease (COPD) acute exacerbation pulmonary vessels cross sectional area (CSA) computed tomography |
| url | https://www.dovepress.com/morphological-changes-in-small-pulmonary-vessels-are-associated-with-s-peer-reviewed-article-COPD |
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