Pulmonary arterial wall disease in COPD and interstitial lung diseases candidates for lung transplantation
Domingo Ribas, Enric (Hospital Universitari Vall d'Hebron)
Grignola, Juan C. (Universidad de la República, Montevideo, Uruguay)
Aguilar Torres, Río (Hospital Universitario de la Princesa (Madrid))
Messeguer, Manuel López (Hospital Universitari Vall d'Hebron)
Roman, Antonio (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Date:	2017
Abstract:	Pulmonary hypertension (PH) associated with lung disease has the worst prognosis of all types of PH. Pulmonary arterial vasculopathy is an early event in the natural history of chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD). The present study characterized the alterations in the structure and function of the pulmonary arterial (PA) wall of COPD and ILD candidates for lung transplantation (LTx). A cohort of 73 patients, 63 pre-LTx (30 COPD, 33 ILD), and ten controls underwent simultaneous right heart catheterisation and intravascular ultrasound (IVUS). Total pulmonary resistance (TPR), capacitance (Cp), and the TPR-Cp relationship were assessed. PA stiffness and the relative area of wall thickness were estimated as pulse PA pressure/IVUS pulsatility and as [(external sectional area-intimal area)/external sectional area] × 100, respectively. Twenty-seven percent of patients had pulmonary arterial wedge pressure > 15 mmHg and were not analyzed. PA stiffness and the area of wall thickness were increased in comparison with controls, even in patients without PH (p < 0. 05). ILD patients showed a significant higher PA stiffness, and lower Cp beyond mean PA pressure (mPAP) and lower area of wall thickness than COPD patients (p < 0. 05). TPR-Cp relationship was shifted downward left for ILD patients. Significant increase of PA stiffness and area of wall thickness were present even in patients without PH and can make the diagnosis of pulmonary vasculopathy at a preclinical stage in PH-lung disease candidates for LTx. ILD patients showed the worst PA stiffness and Cp with respect to COPD.
Note:	Altres ajuts: Partially support by a grant of Boston Scientific Corporation, USA.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Pulmonary hypertension ; Lung transplantation ; Pulmonary arterial wall ; Chronic obstructive pulmonary disease ; Interstitial lung disease
Published in:	Respiratory Research, Vol. 18 (may 2017) , ISSN 1465-993X

DOI: 10.1186/s12931-017-0568-z
PMID: 28477618

9 p, 966.9 KB

The record appears in these collections:
Articles > Research articles
Articles > Published articles