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Pulmonary arterial stiffening in COPD and its implications for right ventricular remodelling.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Weir-McCall, Jonathan R 
Liu-Shiu-Cheong, Patrick Sk 
Struthers, Allan D 
Lipworth, Brian J 
Houston, J Graeme 

Abstract

BACKGROUND: Pulmonary pulse wave velocity (PWV) allows the non-invasive measurement of pulmonary arterial stiffening, but has not previously been assessed in COPD. The aim of the current study was to assess PWV in COPD and its association with right ventricular (RV) remodelling. METHODS: Fifty-eight participants with COPD underwent pulmonary function tests, 6-min walk test and cardiac MRI, while 21 healthy controls (HCs) underwent cardiac MRI. Thirty-two COPD patients underwent a follow-up MRI to assess for longitudinal changes in RV metrics. Cardiac MRI was used to quantify RV mass, volumes and PWV. Differences in continuous variables between the COPD and HC groups was tested using an independent t-test, and associations between PWV and right ventricular parameters was examined using Pearson's correlation coefficient. RESULTS: Those with COPD had reduced pulsatility (COPD (mean±SD):24.88±8.84% vs. HC:30.55±11.28%, p=0.021), pulmonary acceleration time (COPD:104.0±22.9ms vs. HC: 128.1±32.2ms, p<0.001), higher PWV (COPD:2.62±1.29ms-1 vs. HC:1.78±0.72ms-1, p=0.001), lower RV end diastolic volume (COPD:53.6±11.1ml vs. HC:59.9±13.0ml, p=0.037) and RV stroke volume (COPD:31.9±6.9ml/m2 vs. HC:37.1±6.2ml/m2, p=0.003) with no difference in mass (p=0.53). PWV was not associated with right ventricular parameters. CONCLUSIONS: While pulmonary vascular remodelling is present in COPD, cardiac remodelling favours reduced filling rather than increased afterload. Treatment of obstructive lung disease may have greater effect on cardiac function than treatment of pulmonary vascular disease in most COPD patients KEY POINTS: • Pulmonary pulse wave velocity (PWV) is elevated in COPD. • Pulmonary PWV is not associated with right ventricular remodelling. • Right ventricular remodelling is more in keeping with that of reduced filling.

Description

Keywords

Heart ventricles, Magnetic resonance imaging, Pulmonary arteries, Pulmonary disease, chronic obstructive, Pulse-wave analysis, Aged, Female, Heart Ventricles, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Pulmonary Artery, Pulmonary Disease, Chronic Obstructive, Pulse Wave Analysis, Respiratory Function Tests, Ventricular Remodeling

Journal Title

Eur Radiol

Conference Name

Journal ISSN

0938-7994
1432-1084

Volume Title

28

Publisher

Springer Science and Business Media LLC