RT Journal Article
SR Electronic
T1 Impact of exacerbations on pulmonary arterial enlargement in patients with chronic obstructive pulmonary disease
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3410
VO 42
IS Suppl 57
A1 Hirofumi Kiyokawa
A1 Susumu Sato
A1 Motokazu Kato
A1 Shigeo Muro
A1 Toyohiro Hirai
A1 Michiaki Mishima
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P3410.abstract
AB RATIONALE. Pulmonary hypertension is one of the most important abnormalities in COPD patients because it is associated with poor prognosis and impaired quality of life. In the recent study1) it is reported that pulmonary artery enlargement (PA/A ratio: the ratio pulmonary artery diameter (PA) to aortic artery diameter (A)) is associated with severe exacerbations of COPD. However the association between exacerbations and longitudinal changes in PA/A ratio is still unclear. Thus we analyzed the time course of PA/A ratio in relationship to exacerbations in COPD patients.METHOD. Exacerbations were prospectively recorded for 2 years. Exacerbations were defined as symptomatic deterioration requiring additional medical treatment. Baseline and 2-year follow-up CT scans were performed under stable condition. Annual changes of PA/A ratio (ΔPA/A ratio) were compared between patients with and without a history of exacerbations.RESULTS. 66 patients were included. Twenty-nine patients had a history of exacerbations during 2-year follow-up while 37 patients didn’t. In patients with exacerbations ΔPA/A ratio were greater than in patients without exacerbations (1.31 versus 1.11, p=0.03). Multivariate regression analysis showed that a history of exacerbations was an independent predictor of pulmonary artery enlargement (R2=0.10, p=0.02).CONCLUSION. This is the first longitudinal study to demonstrate that exacerbations are associated with pulmonary enlargement in COPD. This study suggested that exacerbations were the cause of the progression in pulmonary hypertension and increase of risk of further exacerbation.1. Wells, J.M. et al. N Engl J Med 2012; 367:913-21.