Combined assessment of pulmonary arterial enlargement and coronary calcification predicts the prognosis of patients with chronic obstructive pulmonary disease - 18/08/21
, Naoya Tanabe b, Akira Oguma a, Kaoruko Shimizu a, Hirokazu Kimura a, Hironi Makita a, c, Susumu Sato b, Toyohiro Hirai b, Isao Yokota d, Satoshi Konno a, Masaharu Nishimura a, cAbstract |
Introduction |
In chronic obstructive pulmonary disease (COPD), chest computed tomography (CT) provides clinically important cardiovascular findings, which include diameter of pulmonary artery (PA), its ratio to the diameter of the aorta (PA:A ratio), and coronary artery calcium score (CACS). The clinical importance of these cardiovascular findings has not been fully assessed in Japan, where cardiovascular morbidity and/or mortality is reported to be much less compared with Western counterparts.
Methods |
PA diameter and PA:A ratio were measured in 172 and 130 patients with COPD who enrolled in the Hokkaido COPD cohort study and the Kyoto University cohort, respectively. CACS was measured in 131 and 128 patients in each cohort.
Results |
While the highest quartile group in PA diameter was associated with higher all-cause mortality compared to the lowest quartile group in both cohorts, individual assessments of PA:A ratio and CACS were not associated with the long-term clinical outcomes. When PA diameter and CACS were combined, patients with PA enlargement (diameter >29.5 mm) and/or coronary calcification (score >440.8) were associated with higher all-cause mortality in both cohorts.
Conclusion |
Combined assessment of PA enlargement and CACS was associated with poor prognosis, which provides a clinical advantage in management of patients with COPD even in geographical regions with lower risk of cardiovascular diseases.
Le texte complet de cet article est disponible en PDF.Keywords : Chronic obstructive pulmonary disease, Pulmonary hypertension, Cardiovascular disease, Mortality, Computed tomography
Abbreviations : list: CACS, COPD, CR score, CT, FEV1, FVC, GOLD, Kco, mMRC, PA, PA:A ratio, post-BD, SGRQ
Plan
Vol 185
Article 106520- août 2021 Retour au numéro
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