Quantitative Dual-Energy Computed Tomography Supports a Vascular Etiology of Smoking-induced Inflammatory Lung Disease.
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
AuthorsIyer, Krishna S
Newell, John D
Fuld, Matthew K
Saha, Punam K
Hoffman, Eric A
MetadataShow full item record
CitationQuantitative Dual-Energy Computed Tomography Supports a Vascular Etiology of Smoking-induced Inflammatory Lung Disease. 2016, 193 (6):652-61 Am. J. Respir. Crit. Care Med.
AbstractEndothelial dysfunction is of interest in relation to smoking-associated emphysema, a component of chronic obstructive pulmonary disease (COPD). We previously demonstrated that computed tomography (CT)-derived pulmonary blood flow (PBF) heterogeneity is greater in smokers with normal pulmonary function tests (PFTs) but who have visual evidence of centriacinar emphysema (CAE) on CT.
We introduced dual-energy CT (DECT) perfused blood volume (PBV) as a PBF surrogate to evaluate whether the CAE-associated increased PBF heterogeneity is reversible with sildenafil.
Seventeen PFT-normal current smokers were divided into CAE-susceptible (SS; n = 10) and nonsusceptible (NS; n = 7) smokers, based on the presence or absence of CT-detected CAE. DECT-PBV images were acquired before and 1 hour after administration of 20 mg oral sildenafil. Regional PBV and PBV coefficients of variation (CV), a measure of spatial blood flow heterogeneity, were determined, followed by quantitative assessment of the central arterial tree.
After sildenafil administration, regional PBV-CV decreased in SS subjects but did not decrease in NS subjects (P < 0.05), after adjusting for age and pack-years. Quantitative evaluation of the central pulmonary arteries revealed higher arterial volume and greater cross-sectional area (CSA) in the lower lobes of SS smokers, which suggested arterial enlargement in response to increased peripheral resistance. After sildenafil, arterial CSA decreased in SS smokers but did not decrease in NS smokers (P < 0.01).
These results demonstrate that sildenafil restores peripheral perfusion and reduces central arterial enlargement in normal SS subjects with little effect in NS subjects, highlighting DECT-PBV as a biomarker of reversible endothelial dysfunction in smokers with CAE.
DescriptionTo access publisher's full text version of this article click on the hyperlink at the bottom of the page
RightsArchived with thanks to American journal of respiratory and critical care medicine
- Quantitative Dual-Energy Computed Tomography Predicts Regional Perfusion Heterogeneity in a Model of Acute Lung Injury.
- Authors: Kay FU, Beraldo MA, Nakamura MAM, De Santis Santiago R, Torsani V, Gomes S, Roldan R, Tucci MR, Abbara S, Amato MBP, Amaro E Jr
- Issue date: 2018 Nov/Dec
- Heterogeneity of pulmonary perfusion as a mechanistic image-based phenotype in emphysema susceptible smokers.
- Authors: Alford SK, van Beek EJ, McLennan G, Hoffman EA
- Issue date: 2010 Apr 20
- Assessing pulmonary perfusion in emphysema: automated quantification of perfused blood volume in dual-energy CTPA.
- Authors: Meinel FG, Graef A, Thieme SF, Bamberg F, Schwarz F, Sommer WH, Helck AD, Neurohr C, Reiser MF, Johnson TR
- Issue date: 2013 Feb
- Decrease in Small Pulmonary Vessels on Chest Computed Tomography in Light Smokers Without COPD: An Early Change, but Correlated with Smoking Index.
- Authors: Saruya S, Yamashiro T, Matsuoka S, Matsushita S, Yagihashi K, Nakajima Y
- Issue date: 2017 Apr
- Dynamic contrast enhanced magnetic resonance perfusion imaging in high-risk smokers and smoking-related COPD: correlations with pulmonary function tests and quantitative computed tomography.
- Authors: Xia Y, Guan Y, Fan L, Liu SY, Yu H, Zhao LM, Li B
- Issue date: 2014 Sep