Pulmonary Microvascular Blood Flow in Mild Chronic Obstructive Pulmonary Disease and Emphysema. The MESA COPD Study
Year: 2015
Type: article
Study design: Observational Study
Abstract: RATIONALE: 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. OBJECTIVES: To investigate whether PMBF is reduced in mild as well as more severe chronic obstructive pulmonary disease (COPD) and emphysema. METHODS: 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. MEASUREMENTS AND MAIN RESULTS: Among 144 participants, PMBF was reduced by 30% in mild COPD, by 29% in moderate COPD, and by 52% in severe COPD (all P < 0.01 vs. control subjects). PMBF was reduced with greater percentage emphysema-950HU and radiologist-defined emphysema, particularly panlobular and centrilobular emphysema (all P ≤ 0.01). Registration of MRI and CT images revealed that PMBF was reduced in mild COPD in both nonemphysematous and emphysematous lung regions. Associations for PMBF were independent of measures of small airways disease on CT and gas trapping largely because emphysema and small airways disease occurred in different smokers. CONCLUSIONS: PMBF was reduced in mild COPD, including in regions of lung without frank emphysema, and may represent a distinct pathological process from small airways disease. PMBF may provide an imaging biomarker for therapeutic strategies targeting the pulmonary microvasculature.
Authors: Katja Hueper, Jens Vogel-Claussen, Megha A. Parikh, John H. M. Austin, David A. Bluemke, James Carr, Jiwoong Choi, Thomas A. Goldstein, Antoinette S. Gomes, Eric A. Hoffman, Steven M. Kawut, Joao Lima, Erin D. Michos, Wendy S. Post, Ming Jack Po, Martin R. Prince, Kiang Liu, Dan Rabinowitz, Jan Skrok, Ben M. Smith, Karol Watson, Youbing Yin, Alan M. Zambeli-Ljepovic, R. Graham Barr
Institutions: Johns Hopkins University, Medizinische Hochschule Hannover, German Center for Lung Research, National Institutes of Health, National Institutes of Health Clinical Center, University of Iowa, Stanford University, University of California, Los Angeles, University of Pennsylvania, Northwestern University, Columbia University, Vida Diagnostics (United States), Columbia University Irving Medical Center
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1261793039, MESA, G1276754516, G1409423729, G1640378483, G2144938473, G22458031, MESA, G2473928466, MESA, G2837638605, G290884426, G291913881, SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--EBCT READING, G3033857187, G336615015, G350785449, MESA, TITLE: MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA), OPTION 3. 4/1/2014 - 3/31/2015. MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA) - READING CENTER, NHLBI, MESA, SUBCLINICAL CARDIOVASCULAR DISEASE STUDY-ULTRASOUND, Mentored Patient-Oriented Research in Pulmonary Arterial Hypertension, MESA, G66341962, MESA, G78770644, G878552033, Combined Cardiopulmonary Failure in COPD: SPIROMICS HF, G9000020463, G9000026317, G9000031215, G9000043366, G9000203389, Environmental Health Sciences Research Center, Precision Medicine Center for Cystic Fibrosis, G991334795
OpenAlex ID: W2104157879