计算机断层扫描显示的肺小动脉和小静脉容量较高与当前和过去吸烟者的死亡率有关。

IF 9.7 1区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL EBioMedicine Pub Date : 2024-10-01 Epub Date: 2024-09-30 DOI:10.1016/j.ebiom.2024.105366
Anastasia K A L Kwee, Eleni-Rosalina Andrinopoulou, Tjeerd van der Veer, Leticia Gallardo-Estrella, Jean-Paul Charbonnier, Stephen M Humphries, David A Lynch, Harm A W M Tiddens, Pim A de Jong, Esther Pompe
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引用次数: 0

摘要

背景:在慢性阻塞性肺病(COPD)中,血管改变已被证明是导致缺氧和肺动脉高压的原因之一,但小血管异常对死亡率的独立影响仍不清楚:我们对计算机断层扫描(CT)上的动脉和静脉尺寸进行了量化,最小可达 0.2 毫米。374名从不吸烟者的小血管体积(小动脉和小静脉的百分位数)分为两组:正常组和高小动脉或小静脉体积组。我们描述了小动脉和小静脉容量大的受试者的临床、生理和成像特征:研究结果:小动脉和小静脉容量高与死亡率有独立关联,调整后的危险比分别为每 mL/m2 增加 1.07 [1.01, 1.14] 和 1.34 [1.21, 1.49]。在 COPDGene 中,447 例(5.7%)受试者的小动脉容积偏高,519 例(9.1%)受试者的小静脉容积偏高,两者都有更多的肺气肿、更多的空气潴留和更严重的冠状动脉钙化:解释:在吸烟者中,小动脉和小静脉的异常高容量都与死亡率有关,因此需要对吸烟者肺部小血管和心脏功能的病因进行研究:获奖编号:U01-HL089897 和 U01-HL089856,由美国国家健康与生物研究所(NHLBI)颁发。COPD 基金会,阿斯利康、勃林格殷格翰、基因泰克、葛兰素史克、诺华、辉瑞、西门子和 Sunovion 提供捐款。
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Higher small pulmonary artery and vein volume on computed tomography is associated with mortality in current and former smokers.

Background: In chronic obstructive pulmonary disease (COPD), vascular alterations have been shown to contribute to hypoxia and pulmonary hypertension, but the independent contribution of small vessel abnormalities to mortality remains unclear.

Methods: We quantified artery and vein dimensions on computed tomography (CT) down to 0.2 mm. Small vessel volumes (<1 mmᴓ) were normalized by body surface area. In 7903 current and former smokers of the COPDGene study (53.2% male) the independent contribution of small artery and small vein volume to all-cause mortality was tested in multivariable Cox models. Additionally, we calculated the 95th percentile of small arteries and veins in 374 never smokers to create two groups: normal and high small artery or vein volume. We describe clinical, physiological and imaging characteristics of subjects with a high small artery and high small vein volume.

Findings: Both high small artery and high small vein volumes were independently associated with mortality with an adjusted hazard ratio of 1.07 [1.01, 1.14] and 1.34 [1.21, 1.49] per mL/m2 increase, respectively. In COPDGene, 447 (5.7%) had high small artery volume and 519 (9.1%) subjects had high small vein volume and both had more emphysema, more air trapping and more severe coronary calcium.

Interpretation: In smokers, abnormally high volumes in small arteries and veins are both relevant for mortality, which urges investigations into the aetiology of small pulmonary vessels and cardiac function in smokers.

Funding: Award Number U01-HL089897 and U01-HL089856 from the NHLBI. COPD Foundation with contributions from AstraZeneca, Boehringer Ingelheim, Genentech, GlaxoSmithKline, Novartis, Pfizer, Siemens, and Sunovion.

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来源期刊
EBioMedicine
EBioMedicine Biochemistry, Genetics and Molecular Biology-General Biochemistry,Genetics and Molecular Biology
CiteScore
17.70
自引率
0.90%
发文量
579
审稿时长
5 weeks
期刊介绍: eBioMedicine is a comprehensive biomedical research journal that covers a wide range of studies that are relevant to human health. Our focus is on original research that explores the fundamental factors influencing human health and disease, including the discovery of new therapeutic targets and treatments, the identification of biomarkers and diagnostic tools, and the investigation and modification of disease pathways and mechanisms. We welcome studies from any biomedical discipline that contribute to our understanding of disease and aim to improve human health.
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