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Pulmonary Vascular Volume by Quantitative CT in Dyspneic Smokers with Minor Emphysema.
- Source :
- COPD: Journal of Chronic Obstructive Pulmonary Disease; Feb2023, Vol. 20 Issue 1, p135-143, 9p
- Publication Year :
- 2023
-
Abstract
- Reduced lung diffusing capacity for carbon monoxide (DL<subscript>CO</subscript>) at rest and increased ventilation (⩒<subscript>E</subscript>)-carbon dioxide output (⩒CO<subscript>2</subscript>) during exercise are frequent findings in dyspneic smokers with largely preserved FEV<subscript>1</subscript>. It remains unclear whether low DL<subscript>CO</subscript> and high ⩒<subscript>E</subscript>-⩒CO<subscript>2</subscript> are mere reflections of alveolar destruction (i.e. emphysema) or impaired pulmonary perfusion in non-emphysematous tissue contributes to these functional abnormalities. Sixty-four smokers (41 males, FEV<subscript>1</subscript>= 84 ± 13%predicted) underwent pulmonary function tests, an incremental exercise test, and quantitative chest computed tomography. Total pulmonary vascular volume (TPVV) was calculated for the entire segmented vascular tree (VIDA Vision™). Using the median % low attenuation area (-950 HU), participants were dichotomized into “Trace” or “Mild” emphysema (E), each group classified into preserved versus reduced DL<subscript>CO</subscript>. Within each emphysema subgroup, participants with abnormally low DL<subscript>CO</subscript> showed lower TPVV, higher ⩒<subscript>E</subscript>-⩒CO<subscript>2</subscript>, and exertional dyspnea than those with preserved DL<subscript>CO</subscript> (p < 0.05). TPVV (r = 0.34; p = 0.01), but not emphysema (r = −0.05; p = 0.67), correlated with lower DL<subscript>CO</subscript> after adjusting for age and height. Despite lower emphysema burden, Trace-E participants with reduced DL<subscript>CO</subscript> had lower TPVV, higher dyspnea, and lower peak work rate than the Mild-E with preserved DL<subscript>CO</subscript> (p < 0.05). Interestingly, TPVV (but not emphysema) correlated inversely with both dyspnea-work rate (r = −0.36, p = 0.004) and dyspnea-⩒<subscript>E</subscript> slopes (r = −0.40, p = 0.001). Reduced pulmonary vascular volume adjusted by emphysema extent is associated with low DL<subscript>CO</subscript> and heightened exertional ventilation in dyspneic smokers with minor emphysema. Impaired perfusion of non-emphysematous regions of the lungs has greater functional and clinical consequences than hitherto assumed in these subjects. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 15412555
- Volume :
- 20
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- COPD: Journal of Chronic Obstructive Pulmonary Disease
- Publication Type :
- Academic Journal
- Accession number :
- 174652570
- Full Text :
- https://doi.org/10.1080/15412555.2023.2169121