Cor Pulmonale Parvus in Chronic Obstructive Pulmonary Disease and Emphysema: The MESA COPD Study

Steven M KAWUT; Hooman D POOR; Jens VOGEL-CLAUSSEN; R Graham Barr; Megha A PARIKH; Katja HUEPER; Benjamin M SMITH; David A BLUEMKE; João A. C LIMA; Martin R PRINCE; Eric A HOFFMAN; John H. M AUSTIN

doi:10.1016/j.jacc.2014.07.991

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Cor Pulmonale Parvus in Chronic Obstructive Pulmonary Disease and Emphysema: The MESA COPD Study

Journal article

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Cor Pulmonale Parvus in Chronic Obstructive Pulmonary Disease and Emphysema: The MESA COPD Study

Steven M KAWUT, Hooman D POOR, Jens VOGEL-CLAUSSEN, R Graham Barr, Megha A PARIKH, Katja HUEPER, Benjamin M SMITH, David A BLUEMKE, João A. C LIMA, Martin R PRINCE, …

Journal of the American College of Cardiology, Vol.64(19), pp.2000-2009

2014

DOI: 10.1016/j.jacc.2014.07.991

PMID: 25440095

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Abstract

Abstract Background The classic cardiovascular complication of chronic obstructive pulmonary disease (COPD) is cor pulmonale or right ventricular (RV) enlargement. Most studies of cor pulmonale were conducted decades ago. Objectives This study sought to examine RV changes in contemporary COPD and emphysema using cardiac magnetic resonance (CMR) imaging. Methods We performed a case-control study nested predominantly in 2 general population studies of 310 participants with COPD and control subjects 50 to 79 years of age with ≥10 pack-years of smoking who were free of clinical cardiovascular disease. RV volumes and mass were assessed using magnetic resonance imaging. COPD and COPD severity were defined according to standard spirometric criteria. The percentage of emphysema was defined as the percentage of lung regions <−950 Hounsfield units on full-lung computed tomography; emphysema subtypes were scored by radiologists. Results were adjusted for age, race/ethnicity, sex, height, weight, smoking status, pack-years, systemic hypertension, and sleep apnea. Results Right ventricular end-diastolic volume (RVEDV) was reduced in COPD compared with control subjects (−7.8 ml; 95% confidence interval: −15.0 to −0.5 ml; p = 0.04). Increasing severity of COPD was associated with lower RVEDV (p = 0.004) and lower RV stroke volume (p < 0.001). RV mass and ejection fraction were similar between the groups. A greater percentage of emphysema also was associated with lower RVEDV (p = 0.005) and stroke volume (p < 0.001), as was the presence of centrilobular and paraseptal emphysema. Conclusions RV volumes are lower without significant alterations in RV mass and ejection fraction in contemporary COPD, and this reduction is related to the greater percentage of emphysema on computed tomography.

Heart

Cardiology. Vascular system

Biological and medical sciences

Medical sciences

Chronic obstructive pulmonary disease, asthma

Pneumology

Details

Title: Subtitle: Cor Pulmonale Parvus in Chronic Obstructive Pulmonary Disease and Emphysema: The MESA COPD Study
Creators: Steven M KAWUT - Departments of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
Hooman D POOR - Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, United States
Jens VOGEL-CLAUSSEN - Department of Radiology, Hannover Medical School, Hannover, Germany
R Graham Barr - Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, United States
Megha A PARIKH - Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, United States
Katja HUEPER - Department of Radiology, Hannover Medical School, Hannover, Germany
Benjamin M SMITH - Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, United States
David A BLUEMKE - Radiology and Imaging Sciences, NIH Clinical Center, Bethesda, Maryland, United States
João A. C LIMA - Departments of Medicine and Radiology, Johns Hopkins University, Baltimore, Maryland, United States
Martin R PRINCE - Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, New York, United States
Eric A HOFFMAN - Department of Radiology, University of Iowa, Iowa City, Iowa, United States
John H. M AUSTIN - Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, New York, United States
Resource Type: Journal article
Publication Details: Journal of the American College of Cardiology, Vol.64(19), pp.2000-2009
DOI: 10.1016/j.jacc.2014.07.991
PMID: 25440095
NLM abbreviation: J Am Coll Cardiol
ISSN: 0735-1097
eISSN: 1558-3597
Publisher: Elsevier; New York, NY
Language: English
Date published: 2014
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
Record Identifier: 9984051893802771

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