Computed Tomographic Measures of Pulmonary Vascular Morphology in Smokers and Their Clinical Implications

Abstract

Smoking-related chronic obstructive pulmonary disease is characterized by distal pruning of the small blood vessels (<5 mm(2)) and loss of tissue in excess of the vasculature. The magnitude of these changes predicts the clinical severity of disease.

Pulmonary Artery Enlargement Is Associated With Cardiac Injury During Severe Exacerbations of COPD

“…In addition, these acute changes could be exaggerated by centralization of blood flow, similar to what we have observed in the stable state of COPD. 23,30 We also observed that younger age was associated with pulmonary arterial enlargement at the time of admission. The mechanism for this phenomenon is unknown and requires further study, although it could be due to impaired vascular distensibility in older patients.…”

Chronic Respiratory Symptoms with Normal Spirometry. A Reliable Clinical Entity?

“…The new data on this clinical condition derived from these cohort studies 24 , which supports the potential role of pulmonary vessels into the pathogenesis of COPD [45][46][47] . Finally, as in most smokers respiratory and non-respiratory symptoms may come before airflow limitation, we need to reconsider the strategy of early diagnosis and management to…”

Update in Pulmonary Vascular Diseases 2013

“…As reflected by the breadth of papers published in the Journal and elsewhere, there has been tremendous progress in all fields of pulmonary vascular disease including diagnosis, understanding mechanisms of disease, use of novel therapeutic targets, and refining our methods to quantitatively assess remodeling of the pulmonary vasculature, for example, by the use of computed tomographic scanning of the chest in diseases that can be complicated by vascular remodeling such as COPD (33). The list of gene mutations associated with PAH continues to grow, with two additional genes since the last update on pulmonary vascular disease.…”