Hyperinflated lungs compress the heart during expiration in COPD patients: a new finding on dynamic-ventilation computed tomography.
Int J Chron Obstruct Pulmon Dis
; 12: 3123-3131, 2017.
Article
em En
| MEDLINE
| ID: mdl-29123390
ABSTRACT
PURPOSE:
The aims of this study were to evaluate dynamic changes in heart size during the respiratory cycle using four-dimensional computed tomography (CT) and to understand the relationship of these changes to airflow limitation in smokers. MATERIALS ANDMETHODS:
A total of 31 smokers, including 13 with COPD, underwent four-dimensional dynamic-ventilation CT during regular breathing. CT data were continuously reconstructed every 0.5 s, including maximum cross-sectional area (CSA) of the heart and mean lung density (MLD). Concordance between the cardiac CSA and MLD time curves was expressed by cross-correlation coefficients. The CT-based cardiothoracic ratio at inspiration and expiration was also calculated. Comparisons of the CT indices between COPD patients and non-COPD smokers were made using the Mann-Whitney test. Spearman rank correlation analysis was used to evaluate associations between CT indices and the forced expiratory volume in 1 s (FEV1.0) relative to the forced vital capacity (FVC).RESULTS:
Cardiac CSA at both inspiration and expiration was significantly smaller in COPD patients than in non-COPD smokers (P<0.05). The cross-correlation coefficient between cardiac CSA and MLD during expiration significantly correlated with FEV1.0/FVC (ρ=0.63, P<0.001), suggesting that heart size decreases during expiration in COPD patients. The change in the cardiothoracic ratio between inspiration and expiration frames was significantly smaller in COPD patients than in non-COPD smokers (P<0.01).CONCLUSION:
Patients with COPD have smaller heart size on dynamic-ventilation CT than non-COPD smokers and have abnormal cardiac compression during expiration.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença Pulmonar Obstrutiva Crônica
/
Expiração
/
Tomografia Computadorizada Multidetectores
/
Coração
/
Cardiopatias
/
Pulmão
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article