Decrease in Small Pulmonary Vessels on Chest Computed Tomography in Light Smokers Without COPD: An Early Change, but Correlated with Smoking Index.

ABSTRACT

PURPOSE: The aim of this study was to evaluate the relationship between the amount of smoking and the cross-sectional area (CSA) of small pulmonary vessels in light smokers without a diagnosis of chronic obstructive pulmonary disease (COPD). METHODS: This retrospective study was approved by our institutional review board, which waived the need for informed consent from patients. The study included 34 current smokers without COPD, who were defined as light smokers based on their smoking history (≤25 pack years). The CSA of small pulmonary vessels (<5 mm2 [CSA<5]) was measured on computed tomography (CT) scans, and the percentage of total CSA of the lung (%CSA<5) was calculated. The extent of emphysema was also assessed as the percentage of low attenuation area (%LAA, <-950 Hounsfield units). The correlations of %CSA<5 and %LAA with pack years were determined using the Spearman rank correlation. RESULTS: There was a significant negative correlation between %CSA<5 and pack years, whereas no significant correlation was found between %LAA and pack years. The correlations between pack years and percent predicted forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity were not significant. CONCLUSIONS: The percentage of total CSA of the lung made up of small pulmonary vessels in light smokers without COPD significantly decreases with increasing amount of smoking, in contrast to emphysema measurements. This suggests that small pulmonary vessels might have been injured or might have degenerated because of smoking, and might represent an initial stage in the development of COPD.