SESSION TITLE: Hot Topics in COPD
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Tuesday, October 27, 2015 at 11:00 AM - 12:15 PM
PURPOSE: We aimed to describe the clinical,functional and computed tomografic (CT) characteristics of patients advanced COPD with and without pulmonary hypertension (PH) and to correlate functional ,arterial blood gases changes and CT measurements of airway remodeling and pulmonary artery to aorta ratio(PA:A) with PH.
METHODS: Data were retrieved from 68 advanced COPD( 3 and 4 GOLD stage)patients who underwent both right heart catheterization(RHC) and computed tomography in a period stability and had no other disease known to cause PH.CT measurements of PA:A ratio and airway wall thickness(WT-Pi10) were used to assess pulmonary artery enlargement and airway remodeling.
RESULTS: Thirty- six of sixty-eight patients with advanced COPD had PH( mean pulmonary arterial pressure [PAPm]>_25 mmHg).There was no difference between the two groups regarding age,sex, and spirometric results,whereas there was more profound hypoxaemia in the PH group.WT-Pi10 was increased in the patients with COPD and PH and positive correlated with PAPm (p= 0.71;P<0.001).WT-Pi10 also was the independent predictor most associated with PAPm elevation ,as compared to arterial blood gas changes(meanly PaO2<60 mmHg) or pulmonary arterial enlargement (diameter ratio between the pulmonary arterial truncus and the ascending aorta).
CONCLUSIONS: This study demonstrates an assosiation among hypoxaemia ,PA:A ratio ,structural alterations and PH in advanced COPD.CT measurements of airway remodeling and PA:A ratio positively correlate with PAPm and could be used to estimate the severity of PH in advanced COPD.Our study also shown that airway remodeling is not limited to airflow limitation in the assessment of COPD severity.Airway remodeling and PA:A ratio are independent predictors for assessment of COPD severity and mortality associated with PH.
CLINICAL IMPLICATIONS: To the best our knowledge,this is the report that points out a relationship among pulmonary function,blood arterial gases ,airway remodling,PA:A ratio and PAP in patients with advanced COPD.So our findings may be very helpful for specialists in pulmonary medicine ,for clinicians , for invasive cardiologists and for specialist radiologists
DISCLOSURE: The following authors have nothing to disclose: Alizamin Sadigov, Sakhavatdin Akhundov, Sadigova Gunel
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