Pulmonary arterial stiffening in COPD and its implications for right ventricular remodelling.

Jonathan R. Weir-McCall, Patrick S. K. Liu Shiu Cheong, Allan D. Struthers, Brian J. Lipworth, J. Graeme Houston (Lead / Corresponding author)

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Abstract

Background: Pulmonary pulse wave velocity (PWV) allows the non-invasive measurement of pulmonary arterial stiffening, but has not previously been assessed in COPD. The aim of the current study was to assess PWV in COPD and its association with right ventricular (RV) remodelling. Methods: Fifty-eight participants with COPD underwent pulmonary function tests, 6-min walk test and cardiac MRI, while 21 healthy controls (HCs) underwent cardiac MRI. Thirty-two COPD patients underwent a follow-up MRI to assess for longitudinal changes in RV metrics. Cardiac MRI was used to quantify RV mass, volumes and PWV. Differences in continuous variables between the COPD and HC groups was tested using an independent t-test, and associations between PWV and right ventricular parameters was examined using Pearson’s correlation coefficient. Results: Those with COPD had reduced pulsatility (COPD (mean±SD):24.88±8.84% vs. HC:30.55±11.28%, p=0.021), pulmonary acceleration time (COPD:104.0±22.9ms vs. HC: 128.1±32.2ms, p<0.001), higher PWV (COPD:2.62±1.29ms -1 vs. HC:1.78±0.72ms -1, p=0.001), lower RV end diastolic volume (COPD:53.6±11.1ml vs. HC:59.9±13.0ml, p=0.037) and RV stroke volume (COPD:31.9±6.9ml/m 2 vs. HC:37.1±6.2ml/m 2, p=0.003) with no difference in mass (p=0.53). PWV was not associated with right ventricular parameters. Conclusions: While pulmonary vascular remodelling is present in COPD, cardiac remodelling favours reduced filling rather than increased afterload. Treatment of obstructive lung disease may have greater effect on cardiac function than treatment of pulmonary vascular disease in most COPD patients Key Points: • Pulmonary pulse wave velocity (PWV) is elevated in COPD. • Pulmonary PWV is not associated with right ventricular remodelling. • Right ventricular remodelling is more in keeping with that of reduced filling.

Original languageEnglish
Pages (from-to)3464-3472
Number of pages9
JournalEuropean Radiology
Volume28
Issue number8
Early online date27 Feb 2018
DOIs
Publication statusPublished - Aug 2018

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Keywords

  • Magnetic resonance imaging
  • Pulmonary arteries
  • Heart ventricles
  • Pulse-wave analysis
  • Pulmonary disease, chronic obstructive
  • Magnetic resonance imaging
  • Pulmonary arteries
  • Heart ventricles
  • Pulmonary disease, chronic obstructive
  • Pulse-wave analysis
  • Pulmonary Artery/diagnostic imaging
  • Pulse Wave Analysis
  • Humans
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive/diagnostic imaging
  • Magnetic Resonance Imaging/methods
  • Male
  • Ventricular Remodeling
  • Female
  • Aged
  • Heart Ventricles/diagnostic imaging
  • Respiratory Function Tests

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