Quantitative analysis of pulmonary vasculature in systemic sclerosis at spirometry-gated chest CT.
Objective: To prospectively investigate whether differences in pulmonary vasculature exist in systemic sclerosis (SSc) and how they are distributed in patients with different pulmonary function.Methods: Seventy-four patients with SSc undergoing chest CT scan for interstitial lung disease (ILD) scree...
| Publicado en: | Annals of the Rheumatic Diseases Vol. 79; no. 9; pp. 1210 - 1218 |
|---|---|
| Autores principales: | , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Sep2020
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=145307352&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 145307352 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00034967 ANR jtl: Annals of the Rheumatic Diseases issn: 00034967 maglogo: N pubinfo: dt: Sep2020 vid: 79 iid: 9 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 145307352 145307352 NLM32606043 145307352 10.1136/annrheumdis-2020-217359 NLM32606043 145307352 ppf: 1210 ppct: 8 formats: tig: atl: Quantitative analysis of pulmonary vasculature in systemic sclerosis at spirometry-gated chest CT. aug: au: Occhipinti, Mariaelena Bruni, Cosimo Camiciottoli, Gianna Bartolucci, Maurizio Bellando-Randone, Silvia Bassetto, Anna Cuomo, Giovanna Giuggioli, Dilia Ciardi, Giulia Fabbrizzi, Alessio Tomassetti, Sara Lavorini, Federico Pistolesi, Massimo Colagrande, Stefano Matucci-Cerinic, Marco affil: Dept Biomedical, Experimental and Clinical Sciences, University of Florence, Florence, Italy sug: subj: Scleroderma, Systemic Spirometry Statistics and Numerical Data Lung Blood Supply Lung Diseases, Interstitial Tomography, X-Ray Computed Statistics and Numerical Data Lung Spirometry Methods Middle Age Lung Diseases, Interstitial Etiology Scleroderma, Systemic Physiopathology Respiratory Function Tests Nonparametric Statistics Logistic Regression Adult Female Tomography, X-Ray Computed Methods Male Prospective Studies Human Vital Capacity Scleroderma, Systemic Complications Validation Studies Comparative Studies Evaluation Research Multicenter Studies Middle Aged: 45-64 years Adult: 19-44 years Female Male ab: Objective: To prospectively investigate whether differences in pulmonary vasculature exist in systemic sclerosis (SSc) and how they are distributed in patients with different pulmonary function.Methods: Seventy-four patients with SSc undergoing chest CT scan for interstitial lung disease (ILD) screening or follow-up were prospectively enrolled. A thorough clinical, laboratory and functional evaluation was performed the same day. Chest CT was spirometry gated at total lung capacity and images were analysed by two automated software programs to quantify emphysema, ILD patterns (ground-glass, reticular, honeycombing), and pulmonary vascular volume (PVV). Patients were divided in restricted (FVC% <80, DLco%<80), isolated DLco% reduction (iDLco- FVC%≥80, DLco%<80) and normals (FVC%≥80, DLco%≥80). Spearman ρ, Mann-Whitney tests and logistic regressions were used to assess for correlations, differences among groups and relationships between continuous variables.Results: Absolute and lung volume normalised PVV (PVV/LV) correlated inversely with functional parameters and positively with all ILD patterns (ρ=0.75 with ground glass, ρ=0.68 with reticular). PVV/LV was the only predictor of DLco at multivariate analysis (p=0.007). Meanwhile, the reticular pattern prevailed in peripheral regions and lower lung thirds, PVV/LV prevailed in central regions and middle lung thirds. iDLco group had a significantly higher PVV/LV (2.2%) than normal (1.6%), but lower than restricted ones (3.8%).Conclusions: Chest CT in SSc detects a progressive increase in PVV/LV as DLco decreases. Redistribution of perfusion to less affected lung regions rather than angiogenesis nearby fibrotic lung may explain the results. Further studies to ascertain whether the increase in PVV/LV reflects a real increase in blood volume are needed. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|