Chest
Original ResearchCOPDImpaired Left Ventricular Filling in COPD and Emphysema: Is It the Heart or the Lungs?: The Multi-Ethnic Study of Atherosclerosis COPD Study
Section snippets
Materials and Methods
See e-Appendix 1 for a complete description of the methods. The MESA COPD Study recruited patients with COPD and control subjects predominantly from MESA, a population-based, prospective cohort study of subclinical atherosclerosis,27 and the Emphysema and Cancer Action Project, a separate, nonoverlapping lung cancer screening study,28 and also from the outpatient community at Columbia University Medical Center. Included participants were 50 to 79 years of age with a ≥ 10 pack-year smoking
Results
Of 201 participants enrolled at one site where pulmonary vein quantification was performed, 165 completed spirometry, thoracic CT scans, and cardiac MRI with pulmonary vein quantification (e-Fig 1). Participants enrolled but not completing all components of the pulmonary vein study had lower lung function, smaller LV dimensions, and were less likely to report current smoking (e-Table 1).
The mean age of the study patients was 68 ± 7 years, and 60% were men. Fifty-three percent had COPD, and 32%
Discussion
Participants with predominantly mild to moderate COPD had reduced total pulmonary vein cross-sectional area as assessed by contrast-enhanced MRI compared with control subjects without COPD. In addition, pulmonary vein size was inversely associated with percent emphysema and was significantly reduced among participants with emphysema on CT scan who did not have clinical COPD. These findings suggest reduced LV preload in both clinical COPD and in patients with emphysema on CT scan.
To our
Acknowledgments
Author contributions: Dr Barr had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Smith: contributed to study concept and design; data analysis and interpretation; and drafting, revising, and final approval of the manuscript and served as principle author.
Dr Prince: contributed to study concept and design, data interpretation, and revision and final approval of the manuscript.
Dr Hoffman: contributed to
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Funding/Support: This study was funded by the National Institutes of Health/National Heart, Lung, and Blood Institute [Grants R01-HL093081, R01-HL077612, R01-HL075476, and N01-HC95159-HC95169]; and Fonds de la recherche en santé Québec.
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