Chest computed tomography could be a simple and useful method for diagnostic evaluation of COPD and pulmonary hypertension, according to a new study, “Computed tomography measurement of pulmonary artery for diagnosis of COPD and its comorbidity pulmonary hypertension,” published in the International Journal of Chronic Obstructive Pulmonary Disease.
Chronic obstructive pulmonary disease (COPD), which covers a range of lung diseases like chronic bronchitis and emphysema, is a common, preventable, and treatable respiratory condition, but a major cause of morbidity and mortality in the world. Pulmonary hypertension (PH), a disease characterized by dangerously high blood pressure in the lungs, can develop secondary to COPD as a comorbidity.
Right heart catheterization (RHC) has been the gold standard for PH diagnosis. However, it is an invasive technique that can cause internal bleeding and pneumothorax and is not suitable for long-term follow-up. Chest computed tomography (CT) has been extensively used to assess lung diseases, its measurements correlate well with the COPD evaluation test, and it is a useful technique for thoracic vascular assessment. Notably, this technique can detect changes in small vessels that may be clinically relevant.
In this study, the research team analyzed the importance of chest computed tomography measurement of the pulmonary artery in the diagnosis of chronic obstructive pulmonary disease (COPD) and pulmonary hypertension (PH). It applied CT to 221 patients with COPD and 115 control patients without cardiovascular or lung conditions. COPD patients were divided into PH (COPD-PH) and non-PH groups according to systolic pulmonary artery pressure. The team then analyzed the CT measured diameters of the main pulmonary artery (MPA), right pulmonary artery (RPA) and left pulmonary artery branches, and ascending aorta (AAo) and descending aorta (Dao), and calculated the ratios of MPA/AAo and MPA/DAo. The researchers found that MPA, RPA, and left pulmonary artery diameters were considerably larger in COPD than in the control group participants, and this increase was more evident in COPD-PH patients. Moreover, MPA/AAo and MAP/DAo increased significantly in both COPD and PH patients.
The researchers acknowledge the retrospective nature of the study, meaning that its main findings might not be widely applicable. They also highlight the need for further prospective studies to validate their findings of chest computed tomography as an effective and relatively simple means of assessing COPD and its comorbidity, PH.