1. Estimated Ventricular Size, Asthma Severity, and Exacerbations
- Author
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Samuel Y. Ash, Gonzalo Vegas Sanchez-Ferrero, Mark L. Schiebler, Farbod N. Rahaghi, Ashish Rai, Carolyn E. Come, James C. Ross, Alysha G. Colon, Juan Carlos Cardet, Eugene R. Bleecker, Mario Castro, John V. Fahy, Sean B. Fain, Benjamin M. Gaston, Eric A. Hoffman, Nizar N. Jarjour, Jason K. Lempel, David T. Mauger, Matthew C. Tattersall, Sally E. Wenzel, Bruce D. Levy, George R. Washko, Elliot Israel, Raul San Jose Estepar, Bruce Levy, George Washko, Manuela Cernadas, Wanda Phipatanakul, Sally Wenzel, Merritt Fajt, Benjamin Gaston, James Chmiel, W. Gerald Teague, Anne-Marie Irani, Serpil Erzurum, Sumita Khatri, Suzy Comhair, Raed Dweik, Kristie Ross, Ross Myers, Wendy Moore, Deborah Meyers, Eugene Bleecker, Stephen Peters, Annette Hastie, Victor Ortega, Greg Hawkins, Xingan Li, Anne Fitzpatrick, Nazar Jarjour, Loren Denlinger, Sean Fain, Ronald Sorkness, Leonard Bacharier, David Gierada, Kenneth Schechtman, Jason Woods, John Fahy, Prescott Woodruff, Ngoc Ly, and David Mauger
- Subjects
Pulmonary and Respiratory Medicine ,COPD ,medicine.medical_specialty ,Aorta ,Exacerbation ,business.industry ,Critical Care and Intensive Care Medicine ,medicine.disease ,Cystic fibrosis ,respiratory tract diseases ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,medicine.artery ,Internal medicine ,Cohort ,Pulmonary artery ,medicine ,Cardiology ,030212 general & internal medicine ,Respiratory system ,Cardiology and Cardiovascular Medicine ,business ,Asthma - Abstract
Background Relative enlargement of the pulmonary artery (PA) on chest CT imaging is associated with respiratory exacerbations in patients with COPD or cystic fibrosis. We sought to determine whether similar findings were present in patients with asthma and whether these findings were explained by differences in ventricular size. Methods We measured the PA and aorta diameters in 233 individuals from the Severe Asthma Research Program III cohort. We also estimated right, left, and total epicardial cardiac ventricular volume indices (eERVVI, eELVVI, and eETVVI, respectively). Associations between the cardiac and PA measures (PA-to-aorta [PA/A] ratio, eERVVI-to-eELVVI [eRV/eLV] ratio, eERVVI, eELVVI, eETVVI) and clinical measures of asthma severity were assessed by Pearson correlation, and associations with asthma severity and exacerbation rate were evaluated by multivariable linear and zero-inflated negative binomial regression. Results Asthma severity was associated with smaller ventricular volumes. For example, those with severe asthma had 36.1 mL/m2 smaller eETVVI than healthy control subjects (P = .003) and 14.1 mL/m2 smaller eETVVI than those with mild/moderate disease (P = .011). Smaller ventricular volumes were also associated with a higher rate of asthma exacerbations, both retrospectively and prospectively. For example, those with an eETVVI less than the median had a 57% higher rate of exacerbations during follow-up than those with eETVVI greater than the median (P = .020). Neither PA/A nor eRV/eLV was associated with asthma severity or exacerbations. Conclusions In patients with asthma, smaller cardiac ventricular size may be associated with more severe disease and a higher rate of asthma exacerbations. Trial Registry ClinicalTrials.gov; No.: NCT01761630; URL: www.clinicaltrials.gov
- Published
- 2020