Document Detail


Percent emphysema and right ventricular structure and function: the Multi-Ethnic Study of Atherosclerosis-Lung and Multi-Ethnic Study of Atherosclerosis-Right Ventricle Studies.
MedLine Citation:
PMID:  23450302     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Severe COPD can lead to cor pulmonale and emphysema and is associated with impaired left ventricular (LV) filling. We evaluated whether emphysema and airflow obstruction would be associated with changes in right ventricular (RV) structure and function and whether these associations would differ by smoking status.
METHODS: The Multi-Ethnic Study of Atherosclerosis (MESA) performed cardiac MRI on 5,098 participants without clinical cardiovascular disease aged 45 to 84 years. RV and emphysema measures were available for 4,188 participants. Percent emphysema was defined as the percentage of voxels below -910 Hounsfield units in the lung windows on cardiac CT scans. Generalized additive models were used to control for confounders and adjust for respective LV parameters.
RESULTS: Participants consisted of 13% current smokers, 36% former smokers, and 52% never smokers. Percent emphysema was inversely associated with RV end-diastolic volume, stroke volume, cardiac output, and mass prior to adjustment for LV measures. After adjustment for LV end-diastolic volume, greater percent emphysema was associated with greater RV end-diastolic volume (+1.5 mL, P=.03) among current smokers, smaller RV end-diastolic volume (-0.8 mL, P=.02) among former smokers, and similar changes among never smokers.
CONCLUSIONS: Percent emphysema was associated with smaller RV volumes and lower mass. The relationship of emphysema to cardiac function is complex but likely involves increased pulmonary vascular resistance, predominantly with reduced cardiac output, pulmonary hyperinflation, and accelerated cardiopulmonary aging.
Authors:
Maria Grau; R Graham Barr; Joao A Lima; Eric A Hoffman; David A Bluemke; J Jeffrey Carr; Harjit Chahal; Paul L Enright; Aditya Jain; Martin R Prince; Steven M Kawut
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chest     Volume:  144     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-07-24     Completed Date:  2013-09-30     Revised Date:  2014-07-01    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  136-44     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
African Continental Ancestry Group
Aged
Aged, 80 and over
Asian Continental Ancestry Group
Cohort Studies
European Continental Ancestry Group
Female
Heart Ventricles / pathology*,  physiopathology*,  radiography
Hispanic Americans
Humans
Lung / pathology,  physiopathology,  radiography
Magnetic Resonance Imaging
Male
Middle Aged
Prevalence
Prospective Studies
Pulmonary Emphysema / epidemiology*,  ethnology*,  etiology
Smoking / adverse effects
Spirometry
Tomography, X-Ray Computed
Ventricular Dysfunction, Right / epidemiology*,  ethnology*,  etiology
Grant Support
ID/Acronym/Agency:
K24 HL103844/HL/NHLBI NIH HHS; N01-HC-95159-N01-HC-95169/HC/NHLBI NIH HHS; P30 ES005605/ES/NIEHS NIH HHS; R01 HL075476/HL/NHLBI NIH HHS; R01 HL077612/HL/NHLBI NIH HHS; R01 HL077612/HL/NHLBI NIH HHS; R01 HL086719/HL/NHLBI NIH HHS; RC1 HL100543/HL/NHLBI NIH HHS
Comments/Corrections

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