Pulmonary hyperinflation due to gas trapping and pulmonary artery size: The MESA COPD Study

Hooman D. Poor; Steven M. Kawut; Chia-Ying Liu; Benjamin M. Smith; Eric A. Hoffman; Joao A. Lima; Bharath Ambale Venkatesh; Erin D. Michos; Martin R. Prince; R. Graham Barr

Pulmonary hyperinflation due to gas trapping and pulmonary artery size: The MESA COPD Study
Poor, Hooman D.
Kawut, Steven M.
Liu, Chia-Ying
Smith, Benjamin M.
Hoffman, Eric A.
Lima, Joao A.
Ambale Venkatesh, Bharath
Michos, Erin D.
Prince, Martin R.
Barr, R. Graham
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Background Pulmonary hypertension is associated with increased morbidity and mortality in chronic obstructive pulmonary disease (COPD). Since pulmonary artery (PA) size increases in pulmonary hypertension, we measured PA cross-sectional area using magnetic resonance imaging (MRI) to test the hypothesis that pulmonary hyperinflation due to gas trapping is associated with PA cross-sectional area in COPD. Methods The MESA COPD Study recruited participants with COPD and controls from two population-based cohort studies ages 50–79 years with 10 or more pack-years and free of clinical cardiovascular disease. Body plethysmography was performed according to standard criteria. Cardiac MRI was performed at functional residual capacity to measure the cross-sectional area of the main PA. Percent emphysema was defined as the percentage of lung voxels less than -950 Hounsfield units as assessed via x-ray computed tomography. Analyses were adjusted for age, gender, height, weight, race-ethnicity, the forced expiratory volume in one second, smoking status, pack-years, lung function, oxygen saturation, blood pressure, left ventricular ejection fraction and percent emphysema. Results Among 106 participants, mean residual volume was 1.98±0.71 L and the mean PA cross-sectional area was 7.23±1.72 cm2. A one standard deviation increase in residual volume was independently associated with an increase in main PA cross-sectional area of 0.55 cm2 (95% CI 0.18 to 0.92; p = 0.003). In contrast, there was no evidence for an association with percent emphysema or total lung capacity. Conclusion Increased residual volume was associated with a larger PA in COPD, suggesting that gas trapping may contribute to pulmonary hypertension in COPD.
Pulmonary hypertension
Magnetic resonance imaging
Pulmonary artery
Lungs--Diseases, Obstructive
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Hooman D. Poor, Steven M. Kawut, Chia-Ying Liu, Benjamin M. Smith, Eric A. Hoffman, Joao A. Lima, Bharath Ambale Venkatesh, Erin D. Michos, Martin R. Prince, R. Graham Barr, , Pulmonary hyperinflation due to gas trapping and pulmonary artery size: The MESA COPD Study, Columbia University Academic Commons, .

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