Abstract
Pulmonary vasculopathy relation with lung function is analyzed in COPD and interstitial lung disease (ILD) candidates for lung transplantation (LT) with precapillary pulmonary hypertension (PH).
106 patients (p) preLT, NYHA 3-4, 41 COPD (59±5 yo, 9 fem), 65 ILD (60±7 yo, 19 fem) were studied with right heart catheterization and IVUS in medium sized pulmonary arteries (PA). Pulmonary hemodynamics, local PA elastic modulus (EM: diastolic lumen area x pulse pressure/(systolic-diastolic lumen area)) and lung function tests were collected.
Characterictics of the population
16% had wedge pressure ≥ 15 mmHg and were excluded. 48% COPD and 43% ILP had PH. EM was obtained in 18/31 COPD and 28/58 ILD. Arterial oxygen pressure was inversely correlated with mPAP in both, COPD (r=-0.44, p<0.01) and ILD (r=-0.35, p<0.01). ILD had higher EM than COPD (p<0.05). FEV1 and EM correlated in COPD but FVC and EM did not correlate in ILD. Neither FEV1 nor CVF correlated with mPAP.
COPD and ILD have different pulmonary vasculopathy. Only COPD correlated parenchymal and vascular disease in the presence of PH, suggesting different pathogenic pathways of PH and vascular remodeling in both diseases.
- © 2014 ERS
