Journal article
Percent emphysema and right ventricular structure and function: the Multi-Ethnic Study of Atherosclerosis-Lung and Multi-Ethnic Study of Atherosclerosis-Right Ventricle Studies
Chest, Vol.144(1), pp.136-144
07/2013
DOI: 10.1378/chest.12-1779
PMCID: PMC3704233
PMID: 23450302
Abstract
Severe COPD can lead to cor pulmonale and emphysema and is associated with impaired left ventricular (LV) filling. We evaluated whether emphysema and airflow obstruction would be associated with changes in right ventricular (RV) structure and function and whether these associations would differ by smoking status.
The Multi-Ethnic Study of Atherosclerosis (MESA) performed cardiac MRI on 5,098 participants without clinical cardiovascular disease aged 45 to 84 years. RV and emphysema measures were available for 4,188 participants. Percent emphysema was defined as the percentage of voxels below -910 Hounsfield units in the lung windows on cardiac CT scans. Generalized additive models were used to control for confounders and adjust for respective LV parameters.
Participants consisted of 13% current smokers, 36% former smokers, and 52% never smokers. Percent emphysema was inversely associated with RV end-diastolic volume, stroke volume, cardiac output, and mass prior to adjustment for LV measures. After adjustment for LV end-diastolic volume, greater percent emphysema was associated with greater RV end-diastolic volume (+1.5 mL, P=.03) among current smokers, smaller RV end-diastolic volume (-0.8 mL, P=.02) among former smokers, and similar changes among never smokers.
Percent emphysema was associated with smaller RV volumes and lower mass. The relationship of emphysema to cardiac function is complex but likely involves increased pulmonary vascular resistance, predominantly with reduced cardiac output, pulmonary hyperinflation, and accelerated cardiopulmonary aging.
Details
- Title: Subtitle
- Percent emphysema and right ventricular structure and function: the Multi-Ethnic Study of Atherosclerosis-Lung and Multi-Ethnic Study of Atherosclerosis-Right Ventricle Studies
- Creators
- Maria Grau - Department of Medicine, Columbia University Medical Center, New York, NY; Cardiovascular Epidemiology and Genetics Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, SpainR Graham Barr - Department of Medicine, Columbia University Medical Center, New York, NY; Department of Epidemiology, Columbia University Medical Center, New York, NY. Electronic address: rgb9@columbia.eduJoao A Lima - Department of Medicine, Johns Hopkins University, Baltimore, MDEric A Hoffman - University of Iowa, Iowa City, IADavid A Bluemke - National Institutes of Health Clinical Center, Bethesda, MDJ Jeffrey Carr - Wake Forest University, Winston-Salem, NCHarjit Chahal - Department of Medicine, Johns Hopkins University, Baltimore, MDPaul L Enright - University of Arizona, Tucson, AZAditya Jain - Department of Medicine, Johns Hopkins University, Baltimore, MDMartin R Prince - Department of Radiology, Columbia University Medical Center, New York, NYSteven M Kawut - Penn Cardiovascular Institute, Department of Medicine and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Resource Type
- Journal article
- Publication Details
- Chest, Vol.144(1), pp.136-144
- Publisher
- United States
- DOI
- 10.1378/chest.12-1779
- PMID
- 23450302
- PMCID
- PMC3704233
- ISSN
- 0012-3692
- eISSN
- 1931-3543
- Grant note
- P30 ES005605 / NIEHS NIH HHS N01HC95169 / NHLBI NIH HHS R01 HL077612 / NHLBI NIH HHS K24 HL103844 / NHLBI NIH HHS R01 HL075476 / NHLBI NIH HHS R01 HL112986 / NHLBI NIH HHS N01-HC-95159-N01-HC-95169 / NHLBI NIH HHS R01 HL086719 / NHLBI NIH HHS RC1 HL100543 / NHLBI NIH HHS
- Language
- English
- Date published
- 07/2013
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
- Record Identifier
- 9984051771602771
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