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Byline: K. Spiropoulos (1), G. Trakada (1), D. Kalamboka (1), C. Kalogeropoulou (2), T. Petsas (2), G. Efremidis (1), M. Tsiamita (1), A. Trakada (1), I. Dimopoulos (2) Keywords: Chronic obstructive pulmonary disease (COPD); Emphysema; Chronic bronchitis; Pulmonary function tests; High resolution computed tomography Abstract: High-resolution computed tomography (HRCT) is a useful method for quantifying the extent of emphysema. Few reports have mentioned the relationships between HRCT scans and pulmonary function tests in chronic obstructive pulmonary disease (COPD). For diagnosis, COPD requires chronic airflow limitation and emphysema and/or chronic bronchitis. We examined 20 who were previous smokers with middle to moderate COPD. All were normocapnic with mean arterial oxygen pressure (PaO.sub.2) 77,52 +- 16,789 mmHg. Forced spirometry, somatic plethysmography and cardiopulmonary exercise test were performed in each patient. HRCT was performed in both full inspiration and full expiration at three levels through the upper (at the aortic arch), lower (2 cm above the diaphragm), and middle lung (midpoint between upper and lower) levels. During expiration all pulmonary function parameters correlated with the HRCT grade in the middle right and left part of the lungs. The middle right part of the lung during expiration correlated statistically significant with MVV (r = -0.681, p =0.001), forced vital capacity (FVC) (r = -0.477, p = 0.027), forced expiratory volume in 1 sec (FEV1) (r = -0.632, p = 0.002), resistance (r = 0.674, p = 0.001), residual volume (RV) (r = 0.733, p = 0.001), total lung capacity (TLC) (r = 0.696, p = 0.001), functional residual capacity (FRC) (r = 0.752, p =0.001) and peak oxygen consumption during exercise (VO.sub.2) (r = -0.493, p = 0.023). The middle left part of the lung during expiration correlated statistically significant with MVV (r = -0.673, p = 0.001), FVC (r = -0.493, p = 0.027), FEV1 (r = -0.629, p = 0.003), resistance (r = 0.593, p = 0.005), RV (r = 0.601, p = 0.005), TLC (r = 0.546, p = 0.012), FRC (r = 0.594, p = 0.006) and peak VO.sub.2 (r = -0.525, p = 0.015). Forced expiratory volume in 1 sec (FEV1), which is a well-established measure of airflow obstruction, correlated with the HRCT grade (1) in the middle left part of the lung during inspiration (r = -0.468, p = 0.035) and during expiration (r = - 0.629, p = 0.003) (2) in the lower right lung during inspiration (r = -0.567, p = 0.007) and during expiration (r = -0.558, p = 0.008) (3) in the lower left lung during inspiration (r = -0.542, p = 0.011) and during expiration (r = -0.558, p = 0.008) (4) in the upper right lung during expiration (r = -0.469, p = 0.037) (5) in the upper left lung during expiration (r = -0.463, p = 0.035) and (6) in the middle right lung during expiration (r = -0.632, p = 0.002). According to our results HRCT was a valuable tool for evaluating the severity of COPD -- especially the middle right and left part of the lungs, during expiration -- and correlated well with pulmonary function tests. Author Affiliation: (1) Division of Pulmonology, Laboratory of Cardiopulmonary Exercise Test, Patras, Greece (2) Department of Radiology, University Hospital of Patras Medical School, Greece Article History: Accepted Date: 28/03/2003

Byline: K. Spiropoulos (1), N. Charokopos (1), T. Petsas (2), G. Trakada (1), D. Dougenis (3), A. Mazarakis (4), J. Christodoulou (4), A. Peristerakis (1), P. Ginopoulos (1), N. Mastronikolis (1), D. Alexopoulos (4) Keywords: Key words: Pulmonary arterial hypertension--Chronic obstructive pulmonary disease--Non-invasive diagnosis. Abstract: The feasibility and reliability of the combination of several noninvasive methods using a multivariate method of analysis to predict pulmonary artery hypertension (PAH) is evaluated in 20 patients with chronic obstructive pulmonary disease. These methods comprised arterial blood gases (Pao .sub.2, Paco .sub.2), pulmonary functional parameters (FEV.sub.1), echo-Doppler parameters (tricuspid regurgitation jets, acceleration time on pulmonary valve), computed tomography measurements (transhilar distance, hilar thoracic index, and measurement of the descending branch of the right pulmonary artery to the lower lobe). A multiple stepwise regression analysis (including one Doppler parameter, two parameters of arterial blood gases, and one functional parameter) revealed a coefficient of determination (R .sup.2) equal to 0.954 for mean pulmonary artery pressure (MPAP) with a standard error of estimate (S.E.E.) of 5.25 mmHg. A stepwise regression analysis including computed tomography and radiographic parameters revealed an R .sup.2 equal to 0.970 for PAP with a S.E.E. of 4.26 mmHg. Logistical regression analysis classified correctly 80% of patients with PAH using noninvasive methods such as the diameter of the main pulmonary artery and the diameter of the left pulmonary arterial branch calculated by computed tomography. Not only the presence of PAH but also the level of MPAP can be estimated by the combination of multiple stepwise and logistical regression analyses. Author Affiliation: (1) Department of Internal Medicine, Division of Pulmonology, University Hospital of Patras, PC 26500 Patras, Greece, GR (2) Department of Radiology, University Hospital of Patras, PC 26500 Patras, Greece, GR (3) Department of Cardiothoracic Surgery, University Hospital of Patras, PC 26500 Patras, Greece, GR (4) Department of Internal Medicine, Division of Cardiology, University Hospital of Patras, PC 26500 Patras, Greece, GR Article note: Accepted for publication: 13 August 1998