Pulmonary Microvascular Blood Flow in Mild Chronic Obstructive Pulmonary Disease and Emphysema. The MESA COPD Study

Smoking-related microvascular loss causes end-organ damage in the kidneys, heart, and brain. Basic research suggests a similar process in the lungs, but no large studies have assessed pulmonary microvascular blood flow (PMBF) in early chronic lung disease. To investigate whether PMBF is reduced in m...

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Bibliographic Details
Published in:American journal of respiratory and critical care medicine 2015-09, Vol.192 (5), p.570-580
Main Authors: Hueper, Katja, Vogel-Claussen, Jens, Parikh, Megha A, Austin, John H M, Bluemke, David A, Carr, James, Choi, Jiwoong, Goldstein, Thomas A, Gomes, Antoinette S, Hoffman, Eric A, Kawut, Steven M, Lima, Joao, Michos, Erin D, Post, Wendy S, Po, Ming Jack, Prince, Martin R, Liu, Kiang, Rabinowitz, Dan, Skrok, Jan, Smith, Ben M, Watson, Karol, Yin, Youbing, Zambeli-Ljepovic, Alan M, Barr, R Graham
Format: Article
Language:English
Subjects:
Aged
Case-Control Studies
Cohort Studies
Female
Gadolinium
Humans
Lung - blood supply
Lung - diagnostic imaging
Lung - pathology
Magnetic Resonance Imaging
Male
Microvessels - pathology
Middle Aged
Original
Perfusion Imaging
Prospective Studies
Pulmonary Circulation
Pulmonary Disease, Chronic Obstructive - diagnostic imaging
Pulmonary Disease, Chronic Obstructive - pathology
Pulmonary Emphysema - diagnostic imaging
Pulmonary Emphysema - pathology
Severity of Illness Index
Smoking - pathology
Spirometry
Tomography, X-Ray Computed
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Summary:Smoking-related microvascular loss causes end-organ damage in the kidneys, heart, and brain. Basic research suggests a similar process in the lungs, but no large studies have assessed pulmonary microvascular blood flow (PMBF) in early chronic lung disease. To investigate whether PMBF is reduced in mild as well as more severe chronic obstructive pulmonary disease (COPD) and emphysema. PMBF was measured using gadolinium-enhanced magnetic resonance imaging (MRI) among smokers with COPD and control subjects age 50 to 79 years without clinical cardiovascular disease. COPD severity was defined by standard criteria. Emphysema on computed tomography (CT) was defined by the percentage of lung regions below -950 Hounsfield units (-950 HU) and by radiologists using a standard protocol. We adjusted for potential confounders, including smoking, oxygenation, and left ventricular cardiac output. Among 144 participants, PMBF was reduced by 30% in mild COPD, by 29% in moderate COPD, and by 52% in severe COPD (all P 
ISSN:1073-449X
1535-4970
DOI:10.1164/rccm.201411-2120OC