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The association of systemic microvascular changes with lung function and lung density: a cross-sectional study
Journal article   Open access   Peer reviewed

The association of systemic microvascular changes with lung function and lung density: a cross-sectional study

Bianca Harris, Ronald Klein, Michael Jerosch-Herold, Eric A Hoffman, Firas S Ahmed, David R Jacobs Jr, Barbara E K Klein, Tien Y Wong, Joao A C Lima, Mary Frances Cotch, …
PloS one, Vol.7(12), pp.e50224-e50224
2012
DOI: 10.1371/journal.pone.0050224
PMCID: PMC3527439
PMID: 23284634
url
https://doi.org/10.1371/journal.pone.0050224View
Published (Version of record) Open Access

Abstract

Smoking causes endothelial dysfunction and systemic microvascular disease with resultant end-organ damage in the kidneys, eyes and heart. Little is known about microvascular changes in smoking-related lung disease. We tested if microvascular changes in the retina, kidneys and heart were associated with obstructive spirometry and low lung density on computed tomography. The Multi-Ethnic Study of Atherosclerosis recruited participants age 45-84 years without clinical cardiovascular disease. Measures of microvascular function included retinal arteriolar and venular caliber, urine albumin-to-creatinine ratio and, in a subset, myocardial blood flow on magnetic resonance imaging. Spirometry was measured following ATS/ERS guidelines. Low attenuation areas (LAA) were measured on lung fields of cardiac computed tomograms. Regression models adjusted for pulmonary and cardiac risk factors, medications and body size. Among 3,397 participants, retinal venular caliber was inversely associated with forced expiratory volume in one second (FEV(1)) (P<0.001) and FEV(1)/forced vital capacity (FVC) ratio (P = 0.04). Albumin-to-creatinine ratio was inversely associated with FEV(1) (P = 0.002) but not FEV(1)/FVC. Myocardial blood flow (n = 126) was associated with lower FEV(1) (P = 0.02), lower FEV(1)/FVC (P = 0.001) and greater percentage LAA (P = 0.04). Associations were of greater magnitude among smokers. Low lung function was associated with microvascular changes in the retina, kidneys and heart, and low lung density was associated with impaired myocardial microvascular perfusion. These cross-sectional results suggest that microvascular damage with end-organ dysfunction in all circulations may pertain to the lung, that lung dysfunction may contribute to systemic microvascular disease, or that there may be a shared predisposition.
Smoking - adverse effects Albuminuria - complications Microvessels - physiopathology Spirometry Kidney - blood supply Humans Middle Aged Male Tomography, X-Ray Computed Lung - cytology Albuminuria - physiopathology Aged, 80 and over Female Lung - pathology Cross-Sectional Studies Coronary Vessels - physiology Retina - physiopathology Lung - physiopathology Lung - physiology Retina - physiology Microvessels - physiology Aged Lung Diseases - complications Lung Diseases - physiopathology Retinal Diseases - physiopathology

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