Pulmonary Arterial Histologic Lesions in Patients With COPD With Severe Pulmonary Hypertension.
Chest
; 156(1): 33-44, 2019 07.
Article
em En
| MEDLINE
| ID: mdl-30872017
ABSTRACT
BACKGROUND:
The development of pulmonary hypertension (PH) during the course of COPD is a well-known phenomenon, with the prevalence depending on the severity of airway obstruction. When mean pulmonary pressure (mPAP) level at rest is ≥ 35 mm Hg or ≥ 25 mm Hg with low cardiac index, the term severe PH is used. For these patients, little is known on the underlying histologic lesions. Our objective was to describe these lesions.METHODS:
From the explants of patients undergoing lung transplantation, we compared retrospectively three groups of patients with COPD severe PH-COPD (n = 10), moderate PH-COPD (mPAP between 25 and 34 mm Hg without low cardiac index) (n = 10), and no PH (mPAP < 25 mm Hg) (n = 10). Histologic analysis of the explanted lungs examined the wall of medium-size arteries, the remodeling of microvessels, and the pulmonary capillary density using morphometric measurements performed on three sections per patient.RESULTS:
Compared with the moderate PH group, the remodeling score of the microvessels was significantly higher (P = .0045) and the capillary density was lower (P = .0049) in the severe PH-COPD group. The alterations of the medium-size arteries, important in group 1 PH, seemed less discriminating.CONCLUSIONS:
Patients with severe PH-COPD appear to have a specific histologic pattern, different from that observed in patients with COPD with moderate PH or without PH.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Artéria Pulmonar
/
Doença Pulmonar Obstrutiva Crônica
/
Hipertensão Pulmonar
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Chest
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
França