Sistema de Salut de Catalunya
Institut Català de la Salut
[Domingo E] Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Departament de Fisiologia, Escola de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. [Grignola JC] Pathophysiology Department, School of Medicine, Hospital de Clínicas, Universidad de la República, Avda Italia 2870, PC 11600 Montevideo, Uruguay. [Aguilar R] Cardiology Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain. [Messeguer ML] Servei de Pneumologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Roman A] Servei de Pneumologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Ciberes, Instituto de Salud Carlos III, Madrid, Spain
Vall d'Hebron Barcelona Hospital Campus
2021-04-27T11:07:25Z
2021-04-27T11:07:25Z
2017-05-06
Malaltia pulmonar obstructiva crònica; Trasplantament de pulmó; Paret arterial pulmonar
Enfermedad pulmonar obstructiva crónica; Trasplante de pulmón; Pared arterial pulmonar
Chronic obstructive pulmonary disease; Lung transplantation; Pulmonary arterial wall
Background Pulmonary hypertension (PH) associated with lung disease has the worst prognosis of all types of PH. Pulmonary arterial vasculopathy is an early event in the natural history of chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD). The present study characterized the alterations in the structure and function of the pulmonary arterial (PA) wall of COPD and ILD candidates for lung transplantation (LTx). Methods A cohort of 73 patients, 63 pre-LTx (30 COPD, 33 ILD), and ten controls underwent simultaneous right heart catheterisation and intravascular ultrasound (IVUS). Total pulmonary resistance (TPR), capacitance (Cp), and the TPR-Cp relationship were assessed. PA stiffness and the relative area of wall thickness were estimated as pulse PA pressure/IVUS pulsatility and as [(external sectional area-intimal area)/external sectional area] × 100, respectively. Results Twenty-seven percent of patients had pulmonary arterial wedge pressure > 15 mmHg and were not analyzed. PA stiffness and the area of wall thickness were increased in comparison with controls, even in patients without PH (p < 0.05). ILD patients showed a significant higher PA stiffness, and lower Cp beyond mean PA pressure (mPAP) and lower area of wall thickness than COPD patients (p < 0.05). TPR-Cp relationship was shifted downward left for ILD patients. Conclusions Significant increase of PA stiffness and area of wall thickness were present even in patients without PH and can make the diagnosis of pulmonary vasculopathy at a preclinical stage in PH-lung disease candidates for LTx. ILD patients showed the worst PA stiffness and Cp with respect to COPD.
Partially support by a grant of Boston Scientific Corporation, USA.
Article
Published version
English
Pulmons - Malalties obstructives; Hipertensió pulmonar; Pulmons - Trasplantació; DISEASES::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Interstitial; DISEASES::Respiratory Tract Diseases::Lung Diseases::Hypertension, Pulmonary; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Surgical Procedures, Operative::Transplantation::Organ Transplantation::Lung Transplantation; ENFERMEDADES::enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares intersticiales; ENFERMEDADES::enfermedades respiratorias::enfermedades pulmonares::hipertensión pulmonar; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::intervenciones quirúrgicas::trasplante::trasplante de órganos::trasplante de pulmón
BMC
Respiratory Research;18
https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-017-0568-z
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - HVH [3396]
