The CT pulmonary vascular parameters and disease severity in COPD patients on acute exacerbation: a correlation analysis

Abstract

Background It is necessary to analyze the CT pulmonary vascular parameters and disease severity in chronic obstructive pulmonary disease (COPD) patients to provide evidence support for the management of COPD. Methods COPD patients on acute exacerbation admitted to our hospital from COPD patients from January 2019 to March 2020 was selected. The characteristics and ratio of the cross-sectional area (CSA) of small pulmonary vessels to the total area of the lung field, and the ratio of pulmonary artery and aorta (PA/A) cross-sectional diameter in patients with COPD were analyzed. Results A total of 128 COPD patients were included. There were significant differences in the duration of COPD, smoking history, the PaO2, PaCO2, pH, and FEV1, FVC and FEV1/FVC among COPD patients with different severity (all p < 0.05). The duration of COPD, smoking, PaO2, PaCO2, CSA and PA/A were correlated with the COPD severity (all p < 0.05). Both CSA, PA/A were correlated with post BD FEV1 (all p < 0.05). The cutoff value of CSA and PA/A for the diagnosis of severe COPD was 0.61 and 0.87 respectively, and the AUC of CSA and PA/A for the diagnosis of severe COPD was 0.724 and 0.782 respectively. Conclusions Patients with CSA ≤ 0.61 and PA/A ≥ 0.87 may have higher risks for severe COPD, and more studies are needed in the future to further elucidate the management of COPD.

Quantitative Assessment the Longitudinal Changes of Pulmonary Vascular Counts in Chronic Obstructive Pulmonary Disease

“…The CSAs of the small pulmonary vessels can be evaluated quantitatively on CT to identify pulmonary vascular alterations in patients with COPD [18,25]. Several studies found the CSAs of small pulmonary vessels to be associated with symptoms, pulmonary artery pressure, pulmonary function, exercise capacity, AE of COPD, and mortality [5,26,27]. In our study, similar to other studies, N total /LSA and N < 5mm /LSA showed a distinct decrease as the GOLD grades progressed.…”

“…COPD have been known as a heterogeneous and complex condition with a variety of pathological and clinical compartments [3,4]. Pulmonary vascular alteration is a major pathophysiological characteristic of COPD [5]. It is estimated that 30-70% of COPD patients have some degree of pulmonary vascular abnormalities due to pulmonary hypertension [6,7].…”

“…The cross-sectional areas (CSAs) of the small pulmonary vessels, quantitatively extracted from volumetric CT, are reliable indicators of pulmonary vascular alteration [9]. CSAs are associated with symptoms, pulmonary function test (PFT), and severity of emphysema [5,8,9]. The extent of emphysema increases over time in patients with COPD [12].…”

Quantitative assessment the longitudinal changes of pulmonary vascular counts in chronic obstructive pulmonary disease

“…COPD have been known as a heterogeneous and complex condition with a variety of pathological and clinical compartments [ 3 , 4 ]. Pulmonary vascular alteration is a major pathophysiological characteristic of COPD [ 5 ]. It is estimated that 30–70% of COPD patients have some degree of pulmonary vascular abnormalities due to pulmonary hypertension [ 6 , 7 ].…”

“…The cross-sectional areas (CSAs) of the small pulmonary vessels, quantitatively extracted from volumetric CT, are reliable indicators of pulmonary vascular alteration [ 9 ]. CSAs are associated with symptoms, pulmonary function test (PFT), and severity of emphysema [ 5 , 8 , 9 ]. The extent of emphysema increases over time in patients with COPD [ 12 ].…”