Match!

Pulmonary vascular pruning in smokers with bronchiectasis.

Published on Oct 1, 2018in ERJ Open Research
· DOI :10.1183/23120541.00044-2018
Alejandro A. Diaz26
Estimated H-index: 26
(Brigham and Women's Hospital),
Diego J. Maselli11
Estimated H-index: 11
(University of Texas Health Science Center at San Antonio)
+ 11 AuthorsRaúl San José Estépar34
Estimated H-index: 34
(Brigham and Women's Hospital)
Abstract
There are few studies looking at the pulmonary circulation in subjects with bronchiectasis. We aimed to evaluate the intraparenchymal pulmonary vascular structure, using noncontrast chest computed tomography (CT), and its clinical implications in smokers with radiographic bronchiectasis. Visual bronchiectasis scoring and quantitative assessment of the intraparenchymal pulmonary vasculature were performed on CT scans from 486 smokers. Clinical, lung function and 6-min walk test (6MWT) data were also collected. The ratio of blood vessel volume in vessels 2 in cross-section (BV5) to total blood vessel volume (TBV) was used as measure of vascular pruning, with lower values indicating more pruning. Whole-lung and lobar BV5/TBV values were determined, and regression analyses were used to assess the differences in BV5/TBV between subjects with and without bronchiectasis. 155 (31.9%) smokers had bronchiectasis, which was, on average, mild in severity. Compared to subjects without bronchiectasis, those with lower-lobe bronchiectasis had greater vascular pruning in adjusted models. Among subjects with bronchiectasis, those with vascular pruning had lower forced expiratory volume in 1 s and 6MWT distance compared to those without vascular pruning. Smokers with mild radiographic bronchiectasis appear to have pruning of the distal pulmonary vasculature and this pruning is associated with measures of disease severity.
  • References (26)
  • Citations (4)
📖 Papers frequently viewed together
30 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
References26
Newest
#1Alejandro A. Diaz (Brigham and Women's Hospital)H-Index: 26
#2Thomas P. Young (Brigham and Women's Hospital)H-Index: 3
Last. Raúl San José Estépar (Brigham and Women's Hospital)H-Index: 34
view all 11 authors...
Background Bronchiectasis is frequent in smokers with COPD; however, there are only limited data on objective assessments of this process. The objective was to assess bronchovascular morphology, calculate the ratio of the diameters of bronchial lumen and adjacent artery (BA ratio), and identify those measurements able to discriminate bronchiectasis. Methods We collected quantitative CT (QCT) measures of BA ratios, peak wall attenuation, wall thickness (WT), wall area, and wall area percent (WA%)...
15 CitationsSource
10 CitationsSource
#1Shinji Saruya (St. Marianna University School of Medicine)H-Index: 3
#2Tsuneo Yamashiro (University of the Ryukyus)H-Index: 16
Last. Yasuo Nakajima (St. Marianna University School of Medicine)H-Index: 24
view all 6 authors...
Purpose The aim of this study was to evaluate the relationship between the amount of smoking and the cross-sectional area (CSA) of small pulmonary vessels in light smokers without a diagnosis of chronic obstructive pulmonary disease (COPD).
4 CitationsSource
#1Diego J. Maselli (University of Texas Health Science Center at San Antonio)H-Index: 11
#2Bravein Amalakuhan (University of Texas Health Science Center at San Antonio)H-Index: 4
Last. Alejandro A. Diaz (Brigham and Women's Hospital)H-Index: 26
view all 4 authors...
SummaryAims Non-cystic fibrosis bronchiectasis (NCFB) is a chronic, progressive respiratory disorder characterised by irreversibly and abnormally dilated airways, persistent cough, excessive sputum production and recurrent pulmonary infections. In the last several decades, its prevalence has increased, making it likely to be encountered in the primary care setting. The aim was to review the clinical presentation and diagnosis of NCFB, with an emphasis on the role of computed tomography (CT). Met...
6 CitationsSource
#1Vidya Navaratnam (Lond: University of London)H-Index: 12
#2Elizabeth R. C. Millett (Lond: University of London)H-Index: 10
Last. Jennifer K. Quint (Lond: University of London)H-Index: 21
view all 8 authors...
Background There are limited data on the burden of cardiovascular comorbidities in people with bronchiectasis. Our cross-sectional study estimates the burden of pre-existing diagnoses of coronary heart disease (CHD) and stroke in people with bronchiectasis compared with the general population. The historical cohort study investigates if individuals with bronchiectasis are at increased risk of incident CHD and stroke events. Methods We used primary care electronic records from the Clinical Practi...
29 CitationsSource
#1J. Michael WellsH-Index: 17
#2Raúl San José Estépar (Brigham and Women's Hospital)H-Index: 34
Last. Craig P. Hersh (Brigham and Women's Hospital)H-Index: 40
view all 17 authors...
Abstract Background Hypoxemia is a major complication of COPD and is a strong predictor of mortality. We previously identified independent risk factors for the presence of resting hypoxemia in the COPDGene cohort. However, little is known about characteristics that predict onset of resting hypoxemia in patients who are normoxic at baseline. We hypothesized that a combination of clinical, physiologic, and radiographic characteristics would predict development of resting hypoxemia after 5-years of...
4 CitationsSource
#1Melissa J. McDonnell (Newcastle University)H-Index: 15
#2Stefano Aliberti (University of Milan)H-Index: 33
Last. James D. Chalmers (Dund.: University of Dundee)H-Index: 44
view all 17 authors...
Summary Background Patients with bronchiectasis often have concurrent comorbidities, but the nature, prevalence, and impact of these comorbidities on disease severity and outcome are poorly understood. We aimed to investigate comorbidities in patients with bronchiectasis and establish their prognostic value on disease severity and mortality rate. Methods An international multicentre cohort analysis of outpatients with bronchiectasis from four European centres followed up for 5 years was done for...
70 CitationsSource
#1Lan Wang (Tongji University)H-Index: 8
#2Sen Jiang (Tongji University)H-Index: 1
Last. Jinming Liu (Tongji University)H-Index: 7
view all 11 authors...
Pulmonary hypertension (PH), as a complication of bronchiectasis, is associated with increased mortality. However, hemodynamic characteristics and the efficacy of pulmonary arterial hypertension (PAH) therapies in patients with bronchiectasis and PH remain unknown. Patients with bilateral bronchiectasis and concurrent PH were included in the study. Patient characteristics at baseline and during follow-up, as well as survival, were analyzed. This observational study was conducted in 36 patients w...
2 CitationsSource
#1Craig P. Hersh (Brigham and Women's Hospital)H-Index: 40
#2Barry J. MakeH-Index: 55
Last. Eclipse InvestigatorsH-Index: 3
view all 26 authors...
Background: Chronic obstructive pulmonary disease (COPD) has been classically divided into blue bloaters and pink puffers. The utility of these clinical subtypes is unclear. However, the broader distinction between airway-predominant and emphysema-predominant COPD may be clinically relevant. The objective was to define clinical features of emphysema-predominant and non-emphysematous COPD patients. Methods: Current and former smokers from the Genetic Epidemiology of COPD Study (COPDGene) had ches...
31 CitationsSource
Rationale: Angiographic investigation suggests that pulmonary vascularremodelinginsmokersischaracterizedbydistalpruningofthe blood vessels. Objectives: Using volumetric computed tomography scans of the chest we sought to quantitatively evaluate this process and assess its clinical associations. Methods: Pulmonary vessels were automatically identified, segmented,andmeasured.Totalbloodvesselvolume(TBV)andthe aggregate vessel volume for vessels less than 5 mm 2 (BV5) were calculatedforalllobes.Thel...
85 CitationsSource
Cited By4
Newest
#1Miguel Ángel Martínez-García (IPN: Instituto Politécnico Nacional)H-Index: 29
#2Casilda OlveiraH-Index: 18
Last. Alvar AgustiH-Index: 90
view all 8 authors...
Resumen En la mayoria de los ambitos de la neumologia se sigue utilizando un principio osleriano (basado en los sintomas y signos) en los que la enfermedad es el centro de toda actividad, pero este paradigma esta cambiando. Actualmente, gracias al reconocimiento de la heterogeneidad y complejidad de las enfermedades pulmonares, la tendencia es a realizar una medicina mas personalizada, de precision, o centrada en el paciente. En la presente revision se intentara establecer la situacion actual so...
Source
#1Miguel Ángel Martínez-García (IPN: Instituto Politécnico Nacional)H-Index: 29
#2Casilda OlveiraH-Index: 18
Last. Alvar Agusti (University of Barcelona)H-Index: 90
view all 8 authors...
Abstract Most areas of respiratory medicine continue to use an Oslerian approach, based on signs and symptoms, in which the disease is the center of all activity. However, this paradigm is changing. Now that lung diseases have been recognized as heterogeneous and complex, we are moving toward more personalized, precise, patient-oriented medicine. The aim of this review was to define the current state of the knowledge on bronchiectasis, or, more accurately, the bronchiectasis syndrome, as a multi...
Source
#1Diego J. MaselliH-Index: 11
#2Surya P. Bhatt (UAB: University of Alabama at Birmingham)H-Index: 24
Last. Barry J. MakeH-Index: 55
view all 21 authors...
The Genetic Epidemiology of COPD (COPDGene) study is a noninterventional, multicenter, longitudinal analysis of > 10,000 subjects, including smokers with a ≥ 10 pack-year history with and without COPD and healthy never smokers. The goal was to characterize disease-related phenotypes and explore associations with susceptibility genes. The subjects were extensively phenotyped with the use of comprehensive symptom and comorbidity questionnaires, spirometry, CT scans of the chest, and genetic and bi...
1 CitationsSource
#1Andrew J. Synn (Harvard University)H-Index: 2
#2Wenyuan Li (Harvard University)H-Index: 9
Last. Mary B. Rice (BIDMC: Beth Israel Deaconess Medical Center)H-Index: 14
view all 11 authors...
Source