Vascular remodeling of the small pulmonary arteries and measures of vascular pruning on computed tomography

Pulmonary hypertension is characterized histologically by intimal and medial thickening in the small pulmonary arteries, eventually resulting in vascular “pruning.” Computed tomography (CT)-based quantification of pruning is associated with clinical measures of pulmonary hypertension, but it is not...

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Autores principales:	Andrew J. Synn, Constance De Margerie-Mellon, Sun Young Jeong, Farbod N. Rahaghi, Iny Jhun, George R. Washko, Raúl San José Estépar, Alexander A. Bankier, Murray A. Mittleman, Paul A. VanderLaan, Mary B. Rice
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701 Diseases of the respiratory system RC705-779
Acceso en línea:	https://doaj.org/article/ee511c7246f649988fe8d0ff582df1dc
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spelling	oai:doaj.org-article:ee511c7246f649988fe8d0ff582df1dc2021-12-02T00:03:35ZVascular remodeling of the small pulmonary arteries and measures of vascular pruning on computed tomography2045-894010.1177/20458940211061284https://doaj.org/article/ee511c7246f649988fe8d0ff582df1dc2021-11-01T00:00:00Zhttps://doi.org/10.1177/20458940211061284https://doaj.org/toc/2045-8940Pulmonary hypertension is characterized histologically by intimal and medial thickening in the small pulmonary arteries, eventually resulting in vascular “pruning.” Computed tomography (CT)-based quantification of pruning is associated with clinical measures of pulmonary hypertension, but it is not established whether CT-based pruning correlates with histologic arterial remodeling. Our sample consisted of 138 patients who underwent resection for early-stage lung adenocarcinoma. From histologic sections, we identified small pulmonary arteries and measured the relative area comprising the intima and media (VWA%), with higher VWA% representing greater histologic remodeling. From pre-operative CTs, we used image analysis algorithms to calculate the small vessel volume fraction (BV5/TBV) as a CT-based indicator of pruning (lower BV5/TBV represents greater pruning). We investigated relationships of CT pruning and histologic remodeling using Pearson correlation, simple linear regression, and multivariable regression with adjustment for age, sex, height, weight, smoking status, and total pack-years. We also tested for effect modification by sex and smoking status. In primary models, more severe CT pruning was associated with greater histologic remodeling. The Pearson correlation coefficient between BV5/TBV and VWA% was –0.41, and in linear regression models, VWA% was 3.13% higher (95% CI: 1.95–4.31%, p < 0.0001) per standard deviation lower BV5/TBV. This association persisted after multivariable adjustment. We found no evidence that these relationships differed by sex or smoking status. Among individuals who underwent resection for lung adenocarcinoma, more severe CT-based vascular pruning was associated with greater histologic arterial remodeling. These findings suggest CT imaging may be a non-invasive indicator of pulmonary vascular pathology.Andrew J. SynnConstance De Margerie-MellonSun Young JeongFarbod N. RahaghiIny JhunGeorge R. WashkoRaúl San José EstéparAlexander A. BankierMurray A. MittlemanPaul A. VanderLaanMary B. RiceSAGE PublishingarticleDiseases of the circulatory (Cardiovascular) systemRC666-701Diseases of the respiratory systemRC705-779ENPulmonary Circulation, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701 Diseases of the respiratory system RC705-779
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 Diseases of the respiratory system RC705-779 Andrew J. Synn Constance De Margerie-Mellon Sun Young Jeong Farbod N. Rahaghi Iny Jhun George R. Washko Raúl San José Estépar Alexander A. Bankier Murray A. Mittleman Paul A. VanderLaan Mary B. Rice Vascular remodeling of the small pulmonary arteries and measures of vascular pruning on computed tomography
description	Pulmonary hypertension is characterized histologically by intimal and medial thickening in the small pulmonary arteries, eventually resulting in vascular “pruning.” Computed tomography (CT)-based quantification of pruning is associated with clinical measures of pulmonary hypertension, but it is not established whether CT-based pruning correlates with histologic arterial remodeling. Our sample consisted of 138 patients who underwent resection for early-stage lung adenocarcinoma. From histologic sections, we identified small pulmonary arteries and measured the relative area comprising the intima and media (VWA%), with higher VWA% representing greater histologic remodeling. From pre-operative CTs, we used image analysis algorithms to calculate the small vessel volume fraction (BV5/TBV) as a CT-based indicator of pruning (lower BV5/TBV represents greater pruning). We investigated relationships of CT pruning and histologic remodeling using Pearson correlation, simple linear regression, and multivariable regression with adjustment for age, sex, height, weight, smoking status, and total pack-years. We also tested for effect modification by sex and smoking status. In primary models, more severe CT pruning was associated with greater histologic remodeling. The Pearson correlation coefficient between BV5/TBV and VWA% was –0.41, and in linear regression models, VWA% was 3.13% higher (95% CI: 1.95–4.31%, p < 0.0001) per standard deviation lower BV5/TBV. This association persisted after multivariable adjustment. We found no evidence that these relationships differed by sex or smoking status. Among individuals who underwent resection for lung adenocarcinoma, more severe CT-based vascular pruning was associated with greater histologic arterial remodeling. These findings suggest CT imaging may be a non-invasive indicator of pulmonary vascular pathology.
format	article
author	Andrew J. Synn Constance De Margerie-Mellon Sun Young Jeong Farbod N. Rahaghi Iny Jhun George R. Washko Raúl San José Estépar Alexander A. Bankier Murray A. Mittleman Paul A. VanderLaan Mary B. Rice
author_facet	Andrew J. Synn Constance De Margerie-Mellon Sun Young Jeong Farbod N. Rahaghi Iny Jhun George R. Washko Raúl San José Estépar Alexander A. Bankier Murray A. Mittleman Paul A. VanderLaan Mary B. Rice
author_sort	Andrew J. Synn
title	Vascular remodeling of the small pulmonary arteries and measures of vascular pruning on computed tomography
title_short	Vascular remodeling of the small pulmonary arteries and measures of vascular pruning on computed tomography
title_full	Vascular remodeling of the small pulmonary arteries and measures of vascular pruning on computed tomography
title_fullStr	Vascular remodeling of the small pulmonary arteries and measures of vascular pruning on computed tomography
title_full_unstemmed	Vascular remodeling of the small pulmonary arteries and measures of vascular pruning on computed tomography
title_sort	vascular remodeling of the small pulmonary arteries and measures of vascular pruning on computed tomography
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/ee511c7246f649988fe8d0ff582df1dc
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Vascular remodeling of the small pulmonary arteries and measures of vascular pruning on computed tomography

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