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Ni Y, Yu Y, Dai R, Shi G. Diffusing capacity in chronic obstructive pulmonary disease assessment: A meta-analysis. Chron Respir Dis 2021; 18:14799731211056340. [PMID: 34855516 PMCID: PMC8649441 DOI: 10.1177/14799731211056340] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 09/25/2021] [Indexed: 12/14/2022] Open
Abstract
To achieve a multidimensional evaluation of chronic obstructive pulmonary disease (COPD) patients, the spirometry measures are supplemented by assessment of symptoms, risk of exacerbations, and CT imaging. However, the measurement of diffusing capacity of the lung for carbon monoxide (DLCO) is not included in most common used models of COPD assessment. Here, we conducted a meta-analysis to evaluate the role of DLCO in COPD assessment.The studies were identified by searching the terms "diffusing capacity" OR "diffusing capacity for carbon monoxide" or "DLCO" AND "COPD" AND "assessment" in Pubmed, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Scopus, and Web of Science databases. The mean difference of DLCO % predict was assessed in COPD patient with different severity (according to GOLD stage and GOLD group), between COPD patients with or without with frequent exacerbation, between survivors and non-survivors, between emphysema dominant and non-emphysema dominant COPD patients, and between COPD patients with or without pulmonary hypertension.43 studies were included in the meta-analysis. DLCO % predicted was significantly lower in COPD patients with more severe airflow limitation (stage II/IV), more symptoms (group B/D), and high exacerbation risk (group C/D). Lower DLCO % predicted was also found in exacerbation patients and non-survivors. Low DLCO % predicted was related to emphysema dominant phenotype, and COPD patients with PH.The current meta-analysis suggested that DLCO % predicted might be an important measurement for COPD patients in terms of severity, exacerbation risk, mortality, emphysema domination, and presence of pulmonary hypertension. As diffusion capacity reflects pulmonary ventilation and perfusion at the same time, the predictive value of DLCO or DLCO combined with other criteria worth further exploration.
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Affiliation(s)
- Yingmeng Ni
- Department of Respiratory and Critical Care
Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of
Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of
Medicine, Shanghai, China
| | - Youchao Yu
- Department of Respiratory and Critical Care
Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of
Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of
Medicine, Shanghai, China
| | - Ranran Dai
- Department of Respiratory and Critical Care
Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of
Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of
Medicine, Shanghai, China
| | - Guochao Shi
- Department of Respiratory and Critical Care
Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of
Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of
Medicine, Shanghai, China
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Huang YS, Hsu HH, Chen JY, Tai MH, Jaw FS, Chang YC. Quantitative computed tomography of pulmonary emphysema and ventricular function in chronic obstructive pulmonary disease patients with pulmonary hypertension. Korean J Radiol 2014; 15:871-7. [PMID: 25469102 PMCID: PMC4248646 DOI: 10.3348/kjr.2014.15.6.871] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 07/18/2014] [Indexed: 12/04/2022] Open
Abstract
Objective This study strived to evaluate the relationship between degree of pulmonary emphysema and cardiac ventricular function in chronic obstructive pulmonary disease (COPD) patients with pulmonary hypertension (PH) using electrocardiographic-gated multidetector computed tomography (CT). Materials and Methods Lung transplantation candidates with the diagnosis of COPD and PH were chosen for the study population, and a total of 15 patients were included. The extent of emphysema is defined as the percentage of voxels below -910 Hounsfield units in the lung windows in whole lung CT without intravenous contrast. Heart function parameters were measured by electrocardiographic-gated CT angiography. Linear regression analysis was conducted to examine the associations between percent emphysema and heart function indicators. Results Significant correlations were found between percent emphysema and right ventricular (RV) measurements, including RV end-diastolic volume (R2 = 0.340, p = 0.023), RV stroke volume (R2 = 0.406, p = 0.011), and RV cardiac output (R2 = 0.382, p = 0.014); the correlations between percent emphysema and left ventricular function indicators were not observed. Conclusion The study revealed that percent emphysema is correlated with RV dysfunction among COPD patients with PH. Based on our findings, percent emphysema can be considered for use as an indicator to predict the severity of right ventricular dysfunction among COPD patients.
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Affiliation(s)
- Yu-Sen Huang
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei 100, Taiwan. ; Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan. ; Department of Medical Imaging, National Taiwan University Hospital Yun Lin Branch, Yun-Lin 640, Taiwan
| | - Hsao-Hsun Hsu
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan
| | - Jo-Yu Chen
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan. ; Department of Medical Imaging, National Taiwan University Hospital Yun Lin Branch, Yun-Lin 640, Taiwan
| | - Mei-Hwa Tai
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan
| | - Fu-Shan Jaw
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei 100, Taiwan
| | - Yeun-Chung Chang
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan
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Li J, Lee A, Cheng Y. A GPS Map for Pulmonary Hypertension: A Review of Imaging Modalities. Curr Hypertens Rep 2013; 15:650-8. [DOI: 10.1007/s11906-013-0392-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Right ventricular function plays an integral role in the pathogenesis and outcome of many cardiovascular diseases. Imaging the right ventricle has long been a challenge because of its complex geometry. In recent years there has been a tremendous expansion in multidetector row CT (MDCT) and its cardiac applications. By judicious modification of contrast medium protocol, it is possible to achieve good opacification of the right-sided cardiac chambers, thereby paving the way for exploring the overshadowed right heart. This article will describe the key features of right heart anatomy, review MDCT acquisition techniques, elaborate the various morphological and functional information that can be obtained, and illustrate some important clinical conditions associated with an abnormal right heart.
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Affiliation(s)
- D Gopalan
- Department of Radiology, Papworth Hospital NHS Trust, Papworth Everard, Cambridge, UK.
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Gao Y, Du X, Liang L, Cao L, Yang Q, Li K. Evaluation of right ventricular function by 64-row CT in patients with chronic obstructive pulmonary disease and cor pulmonale. Eur J Radiol 2012; 81:345-53. [DOI: 10.1016/j.ejrad.2010.11.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2010] [Revised: 10/19/2010] [Accepted: 11/03/2010] [Indexed: 11/16/2022]
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Gao Y, Du X, Qin W, Li K. Assessment of the right ventricular function in patients with chronic obstructive pulmonary disease using MRI. Acta Radiol 2011; 52:711-5. [PMID: 21852436 DOI: 10.1258/ar.2011.100449] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is often associated with changes of the structure and the function of the right ventricle (RV). Therefore, the assessment of right ventricular function and myocardial mass (MM) is clinically important for the evaluation of the severity of COPD, which may provide an objective basis for therapeutic strategy. PURPOSE To assess the right ventricular function and RV MM in patients with mild to severe COPD using magnetic resonance imaging (MRI). MATERIAL AND METHODS We prospectively studied 49 COPD patients determined by the pulmonary function test (PFT). Using the Global Initiative for COPD classification, the COPD patients were divided into three groups according to the severity of the disease: group I = mild (n = 18); group II = moderate (n = 16); and group III = severe (n = 15). The patient groups were compared to a control group consisting of 30 age-matched, healthy, non-smoking subjects. The RV function and RV MM were obtained by 1.5T cardiac MRI in all of the four groups. The results were compared among the four groups using the ANOVA. Pearson's correlation was used to evaluate the relationship between the right ventricular ejection fraction (RVEF) and MM with the PFT results in COPD patients. RESULTS The RVEF was significantly lower in group III than in the other groups (P < 0.01). The RV MM differed significantly among all groups (P < 0.01) and gradually increased with the severity of COPD (P < 0.01). The correlation was significant between the MRI results and forced expiratory volume in 1 s (r = 0.860 for RVEF, r = -0.838 for RV MM) in COPD patients. CONCLUSION The RVEF and RV MM measured by MRI correlate significantly with the severity of disease as determined by PFT in patients with COPD.
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Affiliation(s)
- Yan Gao
- Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Xiangying Du
- Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Wen Qin
- Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Kuncheng Li
- Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing, China
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Schroeder J, Peterschroeder A, Vaske B, Butz T, Barth P, Oldenburg O, Bitter T, Burchert W, Horstkotte D, Langer C. Cardiac volumetry in patients with heart failure and reduced ejection fraction: a comparative study correlating multi-slice computed tomography and magnetic resonance tomography. Reasons for intermodal disagreement. Clin Res Cardiol 2010; 98:739-47. [PMID: 19771459 DOI: 10.1007/s00392-009-0074-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Accepted: 08/26/2009] [Indexed: 11/29/2022]
Abstract
BACKGROUND In humans with normal hearts multi-slice computed tomography (MSCT) based volumetry was shown to correlate well with the gold standard, cardiac magnetic resonance imaging (CMR). We correlated both techniques in patients with various degrees of heart failure and reduced ejection fraction (HFREF) resulting from cardiac dilatation. METHODS Twenty-four patients with a left ventricular enddiastolic volume (LV-EDV) of C 150 ml measured by angiography underwent MSCT and CMR scanning for left and right ventricular (LV, RV) volumetry. MSCT based short cardiac axis views were obtained beginning at the cardiac base advancing to the apex. These were reconstructed in 20 different time windows of the RR-interval (0-95%) serving for identification of enddiastole (ED) and end-systole (ES) and for planimetry. ED and ES volumes and the ejection fraction (EF) were calculated for LV and RV. MSCT based volumetry was compared with CMR. RESULTS MSCT based LV volumetry significantly correlates with CMR as follows: LV-EDV r = 0.94, LV-ESV r = 0.98 and LV-EF r = 0.93, but significantly overestimates LV-EDV and LV-ESV and underestimates EF (P \ 0.0001). MSCT based RV volumetry significantly correlates with CMR as follows: RV-EDV r = 0.79, RVESV r = 0.78 and RV-EF r = 0.73, but again significantly overestimates RV-EDV and RV-ESV and underestimates RV-EF (P \ 0.0001). CONCLUSION When compared with CMR a continuous overestimation of volumes and underestimation of EF needs to be considered when applying MSCT in HFREF patients.
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Affiliation(s)
- Janina Schroeder
- Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, University Hospital of the Ruhr-University Bochum, Bad Oeynhausen, Germany
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Rodriguez Gonzalez-Moro JM, de Lucas Ramos P, Izquierdo Alonso JL, López-Muñiz Ballesteros B, Antón Díaz E, Ribera X, Martín A. Impact of COPD severity on physical disability and daily living activities: EDIP-EPOC I and EDIP-EPOC II studies. Int J Clin Pract 2009; 63:742-50. [PMID: 19392924 DOI: 10.1111/j.1742-1241.2009.02040.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
AIMS The severity of chronic obstructive pulmonary disease (COPD) is associated to patients' health-related quality of life (HRQL). Physical impairment increasingly affects daily activities creating economic, social and personal burden for patients and their families. This burden should be considered in the management of COPD patients; therefore, we intended to assess the impact of the disease severity on physical disability and daily activities. METHODS Two epidemiological observational cross-sectional descriptive studies were carried out in 1596 patients with moderate COPD and 2012 patients with severe or very severe COPD in the routine clinical practice. Demographic and basic clinical-epidemiological data were collected and patients completed questionnaires to assess their physical disability because of COPD [Medical Research Council (MRC)], COPD repercussion on daily activities [London Chest Activity of Daily Living (LCADL)], job, economy and family habits and their health status [EQ-5D visual analogue scale (VAS)]. RESULTS In all, 37% of severe/very severe COPD patients and 10% of moderate (p < 0.0001) had MRC grades 4 and 5. Mean global LCADL was significantly higher in severe/very severe than in moderate patients [29.6 (CI 95%: 28.91-30.25) vs. 21.4 (CI 95%: 20.8-21.9); p < 0.0001]. COPD job impact and economic and family habits repercussions were significantly higher and health status significantly worse in severe/very severe cases than in patients with moderate COPD. CONCLUSIONS COPD severity is highly associated with physical disability by MRC grading, with functionality on daily activities and with impairment of other social and clinical activities. Moderate COPD patients show already a significant degree of impairment in all these parameters.
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