Journal article
Pruning of the Pulmonary Vasculature in Asthma. The Severe Asthma Research Program (SARP) Cohort
American journal of respiratory and critical care medicine, Vol.198(1), pp.39-50
07/01/2018
DOI: 10.1164/rccm.201712-2426OC
PMCID: PMC6034125
PMID: 29672122
Abstract
Loss of the peripheral pulmonary vasculature, termed vascular pruning, is associated with disease severity in patients with chronic obstructive pulmonary disease.
To determine if pulmonary vascular pruning is associated with asthma severity and exacerbations.
We measured the total pulmonary blood vessel volume (TBV) and the blood vessel volume of vessels less than 5 mm
in cross-sectional area (BV5) and of vessels less than 10 mm
(BV10) in cross-sectional area on noncontrast computed tomographic scans of participants from the Severe Asthma Research Program. Lower values of the BV5 to TBV ratio (BV5/TBV) and the BV10 to TBV ratio (BV10/TBV) represented vascular pruning (loss of the peripheral pulmonary vasculature).
Compared with healthy control subjects, patients with severe asthma had more pulmonary vascular pruning. Among those with asthma, those with poor asthma control had more pruning than those with well-controlled disease. Pruning of the pulmonary vasculature was also associated with lower percent predicted FEV
and FVC, greater peripheral and sputum eosinophilia, and higher BAL serum amyloid A/lipoxin A
ratio but not with low-attenuation area or with sputum neutrophilia. Compared with individuals with less pruning, individuals with the most vascular pruning had 150% greater odds of reporting an asthma exacerbation (odds ratio, 2.50; confidence interval, 1.05-5.98; P = 0.039 for BV10/TBV) and reported 45% more asthma exacerbations during follow-up (incidence rate ratio, 1.45; confidence interval, 1.02-2.06; P = 0.036 for BV10/TBV).
Pruning of the peripheral pulmonary vasculature is associated with asthma severity, control, and exacerbations, and with lung function and eosinophilia.
Details
- Title: Subtitle
- Pruning of the Pulmonary Vasculature in Asthma. The Severe Asthma Research Program (SARP) Cohort
- Creators
- Samuel Y Ash - 2 Applied Chest Imaging Laboratory, Brigham and Women's Hospital, Boston, MassachusettsFarbod N Rahaghi - 2 Applied Chest Imaging Laboratory, Brigham and Women's Hospital, Boston, MassachusettsCarolyn E Come - 2 Applied Chest Imaging Laboratory, Brigham and Women's Hospital, Boston, MassachusettsJames C Ross - 2 Applied Chest Imaging Laboratory, Brigham and Women's Hospital, Boston, MassachusettsAlysha G Colon - 3 College of Medicine, University of Florida, Gainesville, FloridaJuan Carlos Cardet-Guisasola - 4 Division of Allergy and Immunology, Department of Medicine, University of South Florida, Tampa, FloridaEleanor M Dunican - 5 St. Vincent's University Hospital, University College Dublin, Dublin, IrelandEugene R Bleecker - 6 Division of Genetics, Genomics and Precision Medicine, University of Arizona, Tucson, ArizonaMario Castro - 7 Division of Pulmonary and Critical Care Medicine, Washington University, St. Louis, MissouriJohn V Fahy - 8 Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, San Francisco, CaliforniaSean B Fain - 11 Department of Biomedical Engineering, andBenjamin M Gaston - 13 Division of Pediatric Pulmonology, Rainbow Babies and Children's Hospital and Cleveland Medical Center, Cleveland, OhioEric A Hoffman - 16 Department of Medicine, University of Iowa, Iowa City, IowaNizar N Jarjour - 17 Division of Pulmonary and Critical Care Medicine, University of Wisconsin, Madison, WisconsinDavid T Mauger - 18 Division of Biostatistics and Bioinformatics, Eberly College of Science, Penn State University, University Park, Pennsylvania; andSally E Wenzel - 19 Division of Pulmonary, Allergy and Critical Care, University of Pittsburgh, Pittsburgh, PennsylvaniaBruce D Levy - 1 Division of Pulmonary and Critical Care Medicine andRaul San Jose Estepar - 2 Applied Chest Imaging Laboratory, Brigham and Women's Hospital, Boston, MassachusettsElliot Israel - 1 Division of Pulmonary and Critical Care Medicine andGeorge R Washko - 2 Applied Chest Imaging Laboratory, Brigham and Women's Hospital, Boston, Massachusetts
- Resource Type
- Journal article
- Publication Details
- American journal of respiratory and critical care medicine, Vol.198(1), pp.39-50
- DOI
- 10.1164/rccm.201712-2426OC
- PMID
- 29672122
- PMCID
- PMC6034125
- NLM abbreviation
- Am J Respir Crit Care Med
- ISSN
- 1073-449X
- eISSN
- 1535-4970
- Publisher
- United States
- Grant note
- T32 HL007633 / NHLBI NIH HHS P30 ES005605 / NIEHS NIH HHS U10 HL109146 / NHLBI NIH HHS R01 HL116931 / NHLBI NIH HHS K23 HL114735 / NHLBI NIH HHS UL1 TR001102 / NCATS NIH HHS U10 HL109250 / NHLBI NIH HHS UL1 TR002373 / NCATS NIH HHS U10 HL109086 / NHLBI NIH HHS U10 HL064313 / NHLBI NIH HHS U10 HL109257 / NHLBI NIH HHS U10 HL109168 / NHLBI NIH HHS U10 HL109164 / NHLBI NIH HHS K23 AI125785 / NIAID NIH HHS K23 HL136905 / NHLBI NIH HHS UL1 TR000427 / NCATS NIH HHS U10 HL109152 / NHLBI NIH HHS R01 HL116473 / NHLBI NIH HHS P30 DK054759 / NIDDK NIH HHS U10 HL109172 / NHLBI NIH HHS UL1 TR001420 / NCATS NIH HHS
- Language
- English
- Date published
- 07/01/2018
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Iowa Neuroscience Institute; Health, Sport, and Human Physiology ; Internal Medicine
- Record Identifier
- 9984051757602771
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