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Simple CT Artery Check Presages COPD Risk

September 4, 2012
Written by: , Filed in: Cardiac Imaging, Chest Radiology
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For a major warning sign, it’s amazingly simple: a CT comparison of the size of two arteries—the aorta and the pulmonary artery—in patients with chronic obstructive pulmonary disease.

The aorta is normally slightly larger. If instead the pulmonary artery becomes larger, then the patient faces a strong risk of worsening COPD. So suggests new research from the University of Alabama at Birmingham.

Mark Dransfield, MD, associate professor of medicine at UAB and medical director of the UAB Lung Health Center, was principal investigator of the study. He said:

Our findings indicate that when the pulmonary artery becomes larger than the aorta, regardless of the underlying cause or other health conditions, the risk of exacerbation increases. In particular, the risk of exacerbation requiring hospitalization increases dramatically.

Dr. Dransfield was quoted in a UAB news release. The study was published online Monday in The New England Journal of Medicine.

Risk of hospitalization may not sound like a big deal, but it can be tremendously ominous. The researchers said it’s associated with a 21 percent chance of death within a year and a 55 percent chance of death within five years for those with COPD. So, said J. Michael Wells, MD, lead author of the study: “Physicians armed with this knowledge may be able to employ a more aggressive treatment to this population in an attempt to reduce their risk of hospitalization.”

Dr. Wells is an assistant professor in pulmonary medicine at UAB. He and the other researchers analyzed data from 3,464 patients in the COPDGene Study, funded by the National Heart, Lung and Blood Institute, and 2,005 patients in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study, funded by GlaxoSmithKline.

And why would the pulmonary artery enlarge? One cause, the researchers said, is a rise in the artery’s blood pressure because of loss of lung tissue and associated difficulty in transferring oxygen to the bloodstream caused by underlying heart disease, which is common in those with COPD.

Related seminar: Computed Body Tomography: The Cutting Edge

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