Pulmonary arterial enlargement predicts long-term survival in COPD patients

PLoS One. 2018 Apr 25;13(4):e0195640. doi: 10.1371/journal.pone.0195640. eCollection 2018.

Abstract

Rationale: Pulmonary artery enlargement (PAE) is associated with exacerbations in Chronic Obstructive Pulmonary Disease (COPD) and with survival in moderate to severe patients. The potential role of PAE in survival prediction has not been compared with other clinical and physiological prognostic markers.

Methods: In 188 patients with COPD, PA diameter was measured on a chest CT and the following clinical and physiological parameters registered: age, gender, smoking status, pack-years history, dyspnea, lung function, exercise capacity, Body Mass Index, BODE index and history of exacerbations in year prior to enrolment. Proportional Cox regression analysis determined the best predictor of all cause survival.

Results: During 83 months (±42), 43 patients died. Age, pack-years history, smoking status, BMI, FEV1%, six minute walking distance, Modified Medical Research Council dyspnea scale, BODE index, exacerbation rate prior to enrollment, PA diameter and PAE (diameter≥30mm) were associated with survival. In the multivariable analysis, age (HR: 1.08; 95%CI: 1.03-1.12, p<0.001) and PAE (HR: 2.78; 95%CI: 1.35-5.75, p = 0.006) were the most powerful parameters associated with all-cause mortality.

Conclusions: In this prospective observational study of COPD patients with mild to moderate airflow limitation, PAE was the best predictor of long-term survival along with age.

Publication types

  • Clinical Trial
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Mass Index
  • Dyspnea / diagnostic imaging
  • Dyspnea / mortality
  • Dyspnea / pathology
  • Exercise Test
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Organ Size
  • Prognosis
  • Proportional Hazards Models
  • Pulmonary Artery / diagnostic imaging*
  • Pulmonary Artery / pathology
  • Pulmonary Disease, Chronic Obstructive / diagnostic imaging*
  • Pulmonary Disease, Chronic Obstructive / mortality
  • Pulmonary Disease, Chronic Obstructive / pathology
  • Respiratory Function Tests
  • Smoking / mortality
  • Smoking / pathology
  • Tomography, X-Ray Computed

Associated data

  • figshare/283dcb16f31a98e610c6

Grants and funding

The authors have reported the following: J. J. Z. is a part-time employee of VisionGate, Inc. None declared (JPDT, A.E., A. B. A., G. B., A. C., J.B., J.G., C.C., B. R. C.). The funder provided support in the form of salaries for author JJZ, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of this author is articulated in the 'author contributions' section.