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dc.contributor.authorIyer, Krishna S
dc.contributor.authorNewell, John D
dc.contributor.authorJin, Dakai
dc.contributor.authorFuld, Matthew K
dc.contributor.authorSaha, Punam K
dc.contributor.authorHansdottir, Sif
dc.contributor.authorHoffman, Eric A
dc.date.accessioned2016-08-17T13:27:34Z
dc.date.available2016-08-17T13:27:34Z
dc.date.issued2016-03-15
dc.date.submitted2016
dc.identifier.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.en
dc.identifier.issn1535-4970
dc.identifier.pmid26569033
dc.identifier.doi10.1164/rccm.201506-1196OC
dc.identifier.urihttp://hdl.handle.net/2336/618493
dc.descriptionTo access publisher's full text version of this article click on the hyperlink at the bottom of the pageen
dc.description.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.
dc.description.abstractWe 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.
dc.description.abstractSeventeen 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.
dc.description.abstractAfter 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).
dc.description.abstractThese 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.
dc.description.sponsorshipNIH Bioengineering Research Partnership Grant/R01HL-112986 NIH MSTP training grant/5T32-GM007337en
dc.language.isoenen
dc.publisherAmer Thoracic Socen
dc.relation.urlhttp://dx.doi.org/ 10.1164/rccm.201506-1196OCen
dc.rightsArchived with thanks to American journal of respiratory and critical care medicineen
dc.subjectReykingaren
dc.subjectLunguen
dc.subjectLungnaþembaen
dc.subjectPAD12
dc.subject.meshAdulten
dc.subject.meshEndothelium, Vascularen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshLungen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshPulmonary Emphysemaen
dc.subject.meshRadiography, Dual-Energy Scanned Projectionen
dc.subject.meshSmokingen
dc.subject.meshTomography, X-Ray Computeden
dc.titleQuantitative Dual-Energy Computed Tomography Supports a Vascular Etiology of Smoking-induced Inflammatory Lung Disease.en
dc.typeArticleen
dc.contributor.department[ 1 ] Univ Iowa, Dept Biomed Engn, Iowa City, IA 52242 USA [ 2 ] Univ Iowa, Dept Radiol, Iowa City, IA 52242 USA [ 3 ] Univ Iowa, Dept Elect Engn, Iowa City, IA 52242 USA [ 4 ] Univ Iowa, Dept Internal Med, Div Pulm Med, Iowa City, IA 52242 USA [ 5 ] Siemens Med Solut Inc, Malvern, PA USA [ 6 ] Landspitali Univ Hosp, Reykjavik, Iceland   Organization-Enhanced Name(s)      Landspitali National University Hospitalen
dc.identifier.journalAmerican journal of respiratory and critical care medicineen
dc.rights.accessClosed - Lokaðen
html.description.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.
html.description.abstractWe 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.
html.description.abstractSeventeen 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.
html.description.abstractAfter 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).
html.description.abstractThese 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.


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