Pulmonary Vascular Volume by Quantitative CT in Dyspneic Smokers with Minor Emphysema
Reduced lung diffusing capacity for carbon monoxide (DL CO ) at rest and increased ventilation (⩒ E )-carbon dioxide output (⩒CO 2 ) during exercise are frequent findings in dyspneic smokers with largely preserved FEV 1 . It remains unclear whether low DL CO and high ⩒ E -⩒CO 2 are mere reflections...
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| Veröffentlicht in: | Chronic obstructive pulmonary disease 2023-12, Vol.20 (1), p.135-143 |
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| creator | Elbehairy, Amany F. Vincent, Sandra G. Phillips, Devin B. James, Matthew D. Veugen, Jenna Parraga, Grace O'Donnell, Denis E. Neder, J. Alberto |
| description | Reduced lung diffusing capacity for carbon monoxide (DL
CO
) at rest and increased ventilation (⩒
E
)-carbon dioxide output (⩒CO
2
) during exercise are frequent findings in dyspneic smokers with largely preserved FEV
1
. It remains unclear whether low DL
CO
and high ⩒
E
-⩒CO
2
are mere reflections of alveolar destruction (i.e. emphysema) or impaired pulmonary perfusion in non-emphysematous tissue contributes to these functional abnormalities. Sixty-four smokers (41 males, FEV
1
= 84 ± 13%predicted) underwent pulmonary function tests, an incremental exercise test, and quantitative chest computed tomography. Total pulmonary vascular volume (TPVV) was calculated for the entire segmented vascular tree (VIDA Vision™). Using the median % low attenuation area (-950 HU), participants were dichotomized into "Trace" or "Mild" emphysema (E), each group classified into preserved versus reduced DL
CO
. Within each emphysema subgroup, participants with abnormally low DL
CO
showed lower TPVV, higher ⩒
E
-⩒CO
2
, and exertional dyspnea than those with preserved DL
CO
(p |
| doi_str_mv | 10.1080/15412555.2023.2169121 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2792506275</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_24e094e41bb14827af278402b2df79ab</doaj_id><sourcerecordid>2792506275</sourcerecordid><originalsourceid>FETCH-LOGICAL-c479t-778841ecc0fd5354c70cd0091c5f1ed076cb1f5fc75880dda212300e394a4efc3</originalsourceid><addsrcrecordid>eNp9kUtv1DAQxy0EoqXwEUA-ctll_IqTG2gpUKkIEG2vluMHdbHjrZ1Q5duTZbd75DSj0f-h0Q-h1wTWBFp4RwQnVAixpkDZmpKmI5Q8Qae7-4qKhj097kKcoBe13gFQwZl4jk5Y00kBnJyi6-9TTHnQZcY3upop6oJvcpySw_2Mf0x6GMOox_DH4c0VDgP-ONft4ILBP1P-7UrFD2G8xV_DkAs-T9vbubqkX6JnXsfqXh3mGbr-dH61-bK6_Pb5YvPhcmW47MaVlG3LiTMGvBVMcCPBWICOGOGJsyAb0xMvvJGibcFaTQllAI51XHPnDTtDF_tcm_Wd2paQlkdU1kH9O-TyS-kyBhOdotxBxx0nfU94S6X2VLYcaE-tl53ul6y3-6xtyfeTq6NKoRoXox5cnqqisqMCGirFIhV7qSm51uL8sZqA2tFRj3TUjo460Fl8bw4VU5-cPboecSyC93tBGHwuST_kEq0a9Rxz8UUPJlTF_t_xF5LonaA</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2792506275</pqid></control><display><type>article</type><title>Pulmonary Vascular Volume by Quantitative CT in Dyspneic Smokers with Minor Emphysema</title><source>Taylor & Francis Open Access</source><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Elbehairy, Amany F. ; Vincent, Sandra G. ; Phillips, Devin B. ; James, Matthew D. ; Veugen, Jenna ; Parraga, Grace ; O'Donnell, Denis E. ; Neder, J. Alberto</creator><creatorcontrib>Elbehairy, Amany F. ; Vincent, Sandra G. ; Phillips, Devin B. ; James, Matthew D. ; Veugen, Jenna ; Parraga, Grace ; O'Donnell, Denis E. ; Neder, J. Alberto ; Canadian Respiratory Research Network (CRRN)</creatorcontrib><description>Reduced lung diffusing capacity for carbon monoxide (DL
CO
) at rest and increased ventilation (⩒
E
)-carbon dioxide output (⩒CO
2
) during exercise are frequent findings in dyspneic smokers with largely preserved FEV
1
. It remains unclear whether low DL
CO
and high ⩒
E
-⩒CO
2
are mere reflections of alveolar destruction (i.e. emphysema) or impaired pulmonary perfusion in non-emphysematous tissue contributes to these functional abnormalities. Sixty-four smokers (41 males, FEV
1
= 84 ± 13%predicted) underwent pulmonary function tests, an incremental exercise test, and quantitative chest computed tomography. Total pulmonary vascular volume (TPVV) was calculated for the entire segmented vascular tree (VIDA Vision™). Using the median % low attenuation area (-950 HU), participants were dichotomized into "Trace" or "Mild" emphysema (E), each group classified into preserved versus reduced DL
CO
. Within each emphysema subgroup, participants with abnormally low DL
CO
showed lower TPVV, higher ⩒
E
-⩒CO
2
, and exertional dyspnea than those with preserved DL
CO
(p < 0.05). TPVV (r = 0.34; p = 0.01), but not emphysema (r = −0.05; p = 0.67), correlated with lower DL
CO
after adjusting for age and height. Despite lower emphysema burden, Trace-E participants with reduced DL
CO
had lower TPVV, higher dyspnea, and lower peak work rate than the Mild-E with preserved DL
CO
(p < 0.05). Interestingly, TPVV (but not emphysema) correlated inversely with both dyspnea-work rate (r = −0.36, p = 0.004) and dyspnea-⩒
E
slopes (r = −0.40, p = 0.001). Reduced pulmonary vascular volume adjusted by emphysema extent is associated with low DL
CO
and heightened exertional ventilation in dyspneic smokers with minor emphysema. Impaired perfusion of non-emphysematous regions of the lungs has greater functional and clinical consequences than hitherto assumed in these subjects.</description><identifier>ISSN: 1541-2555</identifier><identifier>EISSN: 1541-2563</identifier><identifier>DOI: 10.1080/15412555.2023.2169121</identifier><identifier>PMID: 36975041</identifier><language>eng</language><publisher>England: Taylor & Francis</publisher><subject>dlco ; dyspnea ; Dyspnea - diagnostic imaging ; Dyspnea - etiology ; emphysema ; Humans ; Lung - diagnostic imaging ; Male ; Pulmonary Diffusing Capacity ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Emphysema - complications ; Pulmonary Emphysema - diagnostic imaging ; pulmonary vascular volume ; Smokers ; Smoking ; Tomography, X-Ray Computed</subject><ispartof>Chronic obstructive pulmonary disease, 2023-12, Vol.20 (1), p.135-143</ispartof><rights>2023 The Author(s). Published with license by Taylor & Francis Group, LLC. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c479t-778841ecc0fd5354c70cd0091c5f1ed076cb1f5fc75880dda212300e394a4efc3</citedby><cites>FETCH-LOGICAL-c479t-778841ecc0fd5354c70cd0091c5f1ed076cb1f5fc75880dda212300e394a4efc3</cites><orcidid>0000-0003-1586-6897 ; 0000-0002-8019-281X ; 0000-0002-5619-4145 ; 0000-0001-7593-2433 ; 0000-0002-0664-5171 ; 0000-0001-5180-519X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.1080/15412555.2023.2169121$$EPDF$$P50$$Ginformaworld$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.1080/15412555.2023.2169121$$EHTML$$P50$$Ginformaworld$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,860,2096,27479,27901,27902,59116,59117</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36975041$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Elbehairy, Amany F.</creatorcontrib><creatorcontrib>Vincent, Sandra G.</creatorcontrib><creatorcontrib>Phillips, Devin B.</creatorcontrib><creatorcontrib>James, Matthew D.</creatorcontrib><creatorcontrib>Veugen, Jenna</creatorcontrib><creatorcontrib>Parraga, Grace</creatorcontrib><creatorcontrib>O'Donnell, Denis E.</creatorcontrib><creatorcontrib>Neder, J. Alberto</creatorcontrib><creatorcontrib>Canadian Respiratory Research Network (CRRN)</creatorcontrib><title>Pulmonary Vascular Volume by Quantitative CT in Dyspneic Smokers with Minor Emphysema</title><title>Chronic obstructive pulmonary disease</title><addtitle>COPD</addtitle><description>Reduced lung diffusing capacity for carbon monoxide (DL
CO
) at rest and increased ventilation (⩒
E
)-carbon dioxide output (⩒CO
2
) during exercise are frequent findings in dyspneic smokers with largely preserved FEV
1
. It remains unclear whether low DL
CO
and high ⩒
E
-⩒CO
2
are mere reflections of alveolar destruction (i.e. emphysema) or impaired pulmonary perfusion in non-emphysematous tissue contributes to these functional abnormalities. Sixty-four smokers (41 males, FEV
1
= 84 ± 13%predicted) underwent pulmonary function tests, an incremental exercise test, and quantitative chest computed tomography. Total pulmonary vascular volume (TPVV) was calculated for the entire segmented vascular tree (VIDA Vision™). Using the median % low attenuation area (-950 HU), participants were dichotomized into "Trace" or "Mild" emphysema (E), each group classified into preserved versus reduced DL
CO
. Within each emphysema subgroup, participants with abnormally low DL
CO
showed lower TPVV, higher ⩒
E
-⩒CO
2
, and exertional dyspnea than those with preserved DL
CO
(p < 0.05). TPVV (r = 0.34; p = 0.01), but not emphysema (r = −0.05; p = 0.67), correlated with lower DL
CO
after adjusting for age and height. Despite lower emphysema burden, Trace-E participants with reduced DL
CO
had lower TPVV, higher dyspnea, and lower peak work rate than the Mild-E with preserved DL
CO
(p < 0.05). Interestingly, TPVV (but not emphysema) correlated inversely with both dyspnea-work rate (r = −0.36, p = 0.004) and dyspnea-⩒
E
slopes (r = −0.40, p = 0.001). Reduced pulmonary vascular volume adjusted by emphysema extent is associated with low DL
CO
and heightened exertional ventilation in dyspneic smokers with minor emphysema. Impaired perfusion of non-emphysematous regions of the lungs has greater functional and clinical consequences than hitherto assumed in these subjects.</description><subject>dlco</subject><subject>dyspnea</subject><subject>Dyspnea - diagnostic imaging</subject><subject>Dyspnea - etiology</subject><subject>emphysema</subject><subject>Humans</subject><subject>Lung - diagnostic imaging</subject><subject>Male</subject><subject>Pulmonary Diffusing Capacity</subject><subject>Pulmonary Disease, Chronic Obstructive</subject><subject>Pulmonary Emphysema - complications</subject><subject>Pulmonary Emphysema - diagnostic imaging</subject><subject>pulmonary vascular volume</subject><subject>Smokers</subject><subject>Smoking</subject><subject>Tomography, X-Ray Computed</subject><issn>1541-2555</issn><issn>1541-2563</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>0YH</sourceid><sourceid>EIF</sourceid><sourceid>DOA</sourceid><recordid>eNp9kUtv1DAQxy0EoqXwEUA-ctll_IqTG2gpUKkIEG2vluMHdbHjrZ1Q5duTZbd75DSj0f-h0Q-h1wTWBFp4RwQnVAixpkDZmpKmI5Q8Qae7-4qKhj097kKcoBe13gFQwZl4jk5Y00kBnJyi6-9TTHnQZcY3upop6oJvcpySw_2Mf0x6GMOox_DH4c0VDgP-ONft4ILBP1P-7UrFD2G8xV_DkAs-T9vbubqkX6JnXsfqXh3mGbr-dH61-bK6_Pb5YvPhcmW47MaVlG3LiTMGvBVMcCPBWICOGOGJsyAb0xMvvJGibcFaTQllAI51XHPnDTtDF_tcm_Wd2paQlkdU1kH9O-TyS-kyBhOdotxBxx0nfU94S6X2VLYcaE-tl53ul6y3-6xtyfeTq6NKoRoXox5cnqqisqMCGirFIhV7qSm51uL8sZqA2tFRj3TUjo460Fl8bw4VU5-cPboecSyC93tBGHwuST_kEq0a9Rxz8UUPJlTF_t_xF5LonaA</recordid><startdate>20231231</startdate><enddate>20231231</enddate><creator>Elbehairy, Amany F.</creator><creator>Vincent, Sandra G.</creator><creator>Phillips, Devin B.</creator><creator>James, Matthew D.</creator><creator>Veugen, Jenna</creator><creator>Parraga, Grace</creator><creator>O'Donnell, Denis E.</creator><creator>Neder, J. Alberto</creator><general>Taylor & Francis</general><general>Taylor & Francis Group</general><scope>0YH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-1586-6897</orcidid><orcidid>https://orcid.org/0000-0002-8019-281X</orcidid><orcidid>https://orcid.org/0000-0002-5619-4145</orcidid><orcidid>https://orcid.org/0000-0001-7593-2433</orcidid><orcidid>https://orcid.org/0000-0002-0664-5171</orcidid><orcidid>https://orcid.org/0000-0001-5180-519X</orcidid></search><sort><creationdate>20231231</creationdate><title>Pulmonary Vascular Volume by Quantitative CT in Dyspneic Smokers with Minor Emphysema</title><author>Elbehairy, Amany F. ; Vincent, Sandra G. ; Phillips, Devin B. ; James, Matthew D. ; Veugen, Jenna ; Parraga, Grace ; O'Donnell, Denis E. ; Neder, J. Alberto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c479t-778841ecc0fd5354c70cd0091c5f1ed076cb1f5fc75880dda212300e394a4efc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>dlco</topic><topic>dyspnea</topic><topic>Dyspnea - diagnostic imaging</topic><topic>Dyspnea - etiology</topic><topic>emphysema</topic><topic>Humans</topic><topic>Lung - diagnostic imaging</topic><topic>Male</topic><topic>Pulmonary Diffusing Capacity</topic><topic>Pulmonary Disease, Chronic Obstructive</topic><topic>Pulmonary Emphysema - complications</topic><topic>Pulmonary Emphysema - diagnostic imaging</topic><topic>pulmonary vascular volume</topic><topic>Smokers</topic><topic>Smoking</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Elbehairy, Amany F.</creatorcontrib><creatorcontrib>Vincent, Sandra G.</creatorcontrib><creatorcontrib>Phillips, Devin B.</creatorcontrib><creatorcontrib>James, Matthew D.</creatorcontrib><creatorcontrib>Veugen, Jenna</creatorcontrib><creatorcontrib>Parraga, Grace</creatorcontrib><creatorcontrib>O'Donnell, Denis E.</creatorcontrib><creatorcontrib>Neder, J. Alberto</creatorcontrib><creatorcontrib>Canadian Respiratory Research Network (CRRN)</creatorcontrib><collection>Taylor & Francis Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Chronic obstructive pulmonary disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Elbehairy, Amany F.</au><au>Vincent, Sandra G.</au><au>Phillips, Devin B.</au><au>James, Matthew D.</au><au>Veugen, Jenna</au><au>Parraga, Grace</au><au>O'Donnell, Denis E.</au><au>Neder, J. Alberto</au><aucorp>Canadian Respiratory Research Network (CRRN)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pulmonary Vascular Volume by Quantitative CT in Dyspneic Smokers with Minor Emphysema</atitle><jtitle>Chronic obstructive pulmonary disease</jtitle><addtitle>COPD</addtitle><date>2023-12-31</date><risdate>2023</risdate><volume>20</volume><issue>1</issue><spage>135</spage><epage>143</epage><pages>135-143</pages><issn>1541-2555</issn><eissn>1541-2563</eissn><abstract>Reduced lung diffusing capacity for carbon monoxide (DL
CO
) at rest and increased ventilation (⩒
E
)-carbon dioxide output (⩒CO
2
) during exercise are frequent findings in dyspneic smokers with largely preserved FEV
1
. It remains unclear whether low DL
CO
and high ⩒
E
-⩒CO
2
are mere reflections of alveolar destruction (i.e. emphysema) or impaired pulmonary perfusion in non-emphysematous tissue contributes to these functional abnormalities. Sixty-four smokers (41 males, FEV
1
= 84 ± 13%predicted) underwent pulmonary function tests, an incremental exercise test, and quantitative chest computed tomography. Total pulmonary vascular volume (TPVV) was calculated for the entire segmented vascular tree (VIDA Vision™). Using the median % low attenuation area (-950 HU), participants were dichotomized into "Trace" or "Mild" emphysema (E), each group classified into preserved versus reduced DL
CO
. Within each emphysema subgroup, participants with abnormally low DL
CO
showed lower TPVV, higher ⩒
E
-⩒CO
2
, and exertional dyspnea than those with preserved DL
CO
(p < 0.05). TPVV (r = 0.34; p = 0.01), but not emphysema (r = −0.05; p = 0.67), correlated with lower DL
CO
after adjusting for age and height. Despite lower emphysema burden, Trace-E participants with reduced DL
CO
had lower TPVV, higher dyspnea, and lower peak work rate than the Mild-E with preserved DL
CO
(p < 0.05). Interestingly, TPVV (but not emphysema) correlated inversely with both dyspnea-work rate (r = −0.36, p = 0.004) and dyspnea-⩒
E
slopes (r = −0.40, p = 0.001). Reduced pulmonary vascular volume adjusted by emphysema extent is associated with low DL
CO
and heightened exertional ventilation in dyspneic smokers with minor emphysema. Impaired perfusion of non-emphysematous regions of the lungs has greater functional and clinical consequences than hitherto assumed in these subjects.</abstract><cop>England</cop><pub>Taylor & Francis</pub><pmid>36975041</pmid><doi>10.1080/15412555.2023.2169121</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1586-6897</orcidid><orcidid>https://orcid.org/0000-0002-8019-281X</orcidid><orcidid>https://orcid.org/0000-0002-5619-4145</orcidid><orcidid>https://orcid.org/0000-0001-7593-2433</orcidid><orcidid>https://orcid.org/0000-0002-0664-5171</orcidid><orcidid>https://orcid.org/0000-0001-5180-519X</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Chronic obstructive pulmonary disease, 2023-12, Vol.20 (1), p.135-143 |
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| language | eng |
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| source | Taylor & Francis Open Access; MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | dlco dyspnea Dyspnea - diagnostic imaging Dyspnea - etiology emphysema Humans Lung - diagnostic imaging Male Pulmonary Diffusing Capacity Pulmonary Disease, Chronic Obstructive Pulmonary Emphysema - complications Pulmonary Emphysema - diagnostic imaging pulmonary vascular volume Smokers Smoking Tomography, X-Ray Computed |
| title | Pulmonary Vascular Volume by Quantitative CT in Dyspneic Smokers with Minor Emphysema |
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