Pulmonary Microvascular Blood Flow in Mild Chronic Obstructive Pulmonary Disease and Emphysema. The MESA COPD Study

Katja Hueper; Jens Vogel-Claussen; Megha A Parikh; John H M Austin; David A Bluemke; James Carr; Jiwoong Choi; Thomas A Goldstein; Antoinette S Gomes; Eric A Hoffman; Steven M Kawut; Joao Lima; Erin D Michos; Wendy S Post; Ming Jack Po; Martin R Prince; Kiang Liu; Dan Rabinowitz; Jan Skrok; Ben M Smith; Karol Watson; Youbing Yin; Alan M Zambeli-Ljepovic; R Graham Barr

doi:10.1164/rccm.201411-2120OC

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Pulmonary Microvascular Blood Flow in Mild Chronic Obstructive Pulmonary Disease and Emphysema. The MESA COPD Study

Journal article

Open access

Peer reviewed

Pulmonary Microvascular Blood Flow in Mild Chronic Obstructive Pulmonary Disease and Emphysema. The MESA COPD Study

Katja Hueper, Jens Vogel-Claussen, Megha A Parikh, John H M Austin, David A Bluemke, James Carr, Jiwoong Choi, Thomas A Goldstein, Antoinette S Gomes, Eric A Hoffman, …

American journal of respiratory and critical care medicine, Vol.192(5), pp.570-580

09/01/2015

DOI: 10.1164/rccm.201411-2120OC

PMCID: PMC4595687

PMID: 26067761

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Abstract

Smoking-related microvascular loss causes end-organ damage in the kidneys, heart, and brain. Basic research suggests a similar process in the lungs, but no large studies have assessed pulmonary microvascular blood flow (PMBF) in early chronic lung disease. To investigate whether PMBF is reduced in mild as well as more severe chronic obstructive pulmonary disease (COPD) and emphysema. PMBF was measured using gadolinium-enhanced magnetic resonance imaging (MRI) among smokers with COPD and control subjects age 50 to 79 years without clinical cardiovascular disease. COPD severity was defined by standard criteria. Emphysema on computed tomography (CT) was defined by the percentage of lung regions below -950 Hounsfield units (-950 HU) and by radiologists using a standard protocol. We adjusted for potential confounders, including smoking, oxygenation, and left ventricular cardiac output. Among 144 participants, PMBF was reduced by 30% in mild COPD, by 29% in moderate COPD, and by 52% in severe COPD (all P < 0.01 vs. control subjects). PMBF was reduced with greater percentage emphysema-950HU and radiologist-defined emphysema, particularly panlobular and centrilobular emphysema (all P ≤ 0.01). Registration of MRI and CT images revealed that PMBF was reduced in mild COPD in both nonemphysematous and emphysematous lung regions. Associations for PMBF were independent of measures of small airways disease on CT and gas trapping largely because emphysema and small airways disease occurred in different smokers. PMBF was reduced in mild COPD, including in regions of lung without frank emphysema, and may represent a distinct pathological process from small airways disease. PMBF may provide an imaging biomarker for therapeutic strategies targeting the pulmonary microvasculature.

Magnetic Resonance Imaging

Severity of Illness Index

Spirometry

Lung - pathology

Prospective Studies

Humans

Middle Aged

Microvessels - pathology

Pulmonary Emphysema - pathology

Gadolinium

Male

Tomography, X-Ray Computed

Lung - diagnostic imaging

Pulmonary Disease, Chronic Obstructive - pathology

Pulmonary Emphysema - diagnostic imaging

Case-Control Studies

Pulmonary Circulation

Smoking - pathology

Female

Pulmonary Disease, Chronic Obstructive - diagnostic imaging

Aged

Lung - blood supply

Perfusion Imaging

Cohort Studies

Details

Title: Subtitle: Pulmonary Microvascular Blood Flow in Mild Chronic Obstructive Pulmonary Disease and Emphysema. The MESA COPD Study
Creators: Katja Hueper - 2 Department of Radiology and Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover Medical School, Hannover, Germany
Jens Vogel-Claussen - 2 Department of Radiology and Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover Medical School, Hannover, Germany
Megha A Parikh - 3 Department of Medicine
John H M Austin - 4 Department of Radiology, and
David A Bluemke - 5 Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland
James Carr - 6 Department of Radiology and
Jiwoong Choi - 8 IIHR-Hydroscience & Engineering
Thomas A Goldstein - 9 Department of Biomedical Engineering, Stanford University, Stanford, California
Antoinette S Gomes - 10 Department of Radiology and
Eric A Hoffman - 12 Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa
Steven M Kawut - 13 Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Joao Lima - 14 Department of Medicine, Johns Hopkins University, Baltimore, Maryland
Erin D Michos - 14 Department of Medicine, Johns Hopkins University, Baltimore, Maryland
Wendy S Post - 14 Department of Medicine, Johns Hopkins University, Baltimore, Maryland
Ming Jack Po - 15 Department of Biomedical Engineering and
Martin R Prince - 4 Department of Radiology, and
Kiang Liu - 16 Department of Biostatistics, Northwestern University, Chicago, Illinois
Dan Rabinowitz - 17 Department of Statistics, Columbia University, New York, New York; and
Jan Skrok - 1 Department of Radiology and
Ben M Smith - 3 Department of Medicine
Karol Watson - 18 Department of Medicine, University of California at Los Angeles, Los Angeles, California
Youbing Yin - 19 VIDA Diagnostics, Coralville, Iowa
Alan M Zambeli-Ljepovic - 15 Department of Biomedical Engineering and
R Graham Barr - 20 Department of Epidemiology, Columbia University Medical Center, New York, New York
Resource Type: Journal article
Publication Details: American journal of respiratory and critical care medicine, Vol.192(5), pp.570-580
DOI: 10.1164/rccm.201411-2120OC
PMID: 26067761
PMCID: PMC4595687
NLM abbreviation: Am J Respir Crit Care Med
ISSN: 1073-449X
eISSN: 1535-4970
Publisher: United States
Grant note: N01-HC95161 / NHLBI NIH HHS P30 ES005605 / NIEHS NIH HHS N01HC95169 / NHLBI NIH HHS R01-HL093081 / NHLBI NIH HHS N01-HC95169 / NHLBI NIH HHS N01-HC95162 / NHLBI NIH HHS N01-HC95168 / NHLBI NIH HHS R01 HL093081 / NHLBI NIH HHS R01-HL075476 / NHLBI NIH HHS R01 HL112986 / NHLBI NIH HHS N01-HC95165 / NHLBI NIH HHS N01-HC95163 / NHLBI NIH HHS R01-HL077612 / NHLBI NIH HHS R01-HL-112986 / NHLBI NIH HHS N01-HC95167 / NHLBI NIH HHS UL1 RR024156 / NCRR NIH HHS R01 HL077612 / NHLBI NIH HHS N01-HC95159 / NHLBI NIH HHS N01-HC95160 / NHLBI NIH HHS N01-HC95164 / NHLBI NIH HHS N01-HC95166 / NHLBI NIH HHS K24 HL103844 / NHLBI NIH HHS R01 HL075476 / NHLBI NIH HHS P30 DK054759 / NIDDK NIH HHS
Language: English
Date published: 09/01/2015
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Mechanical Engineering; Internal Medicine
Record Identifier: 9984051777502771

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