Smoking related pulmonary vascular disease has been demonstrated to be an independent predictor of morbidity and mortality in patients with COPD. Previous investigation and observation suggests that there are several types of pathologic pulmonary vascular remodeling possible in smokers. These range from inflammatory remodeling with progressive luminal occlusion, aberrant vessel elongation in regions of hyperinflation, and outright loss of vasculature in regions of severe emphysematous destruction. While there are existing tools that may be used to investigate the aggregate effect of these processes such as right heart catheterization, echocardiography, and measurements of diffusing capacity for carbon monoxide (DLCO), none can differentiate the types of vascular remodeling/deformation present nor their relative contribution to clinical impairment. The purpose of this investigation is to improve understanding of the clinical impact and epidemiologic associations of pulmonary vascular remodeling in smokers. We will do this by performing CT based quantitative measures of the mediastinal (Aim 1) and intra-parenchymal vasculature (Aim 2) in all subjects enrolled in the COPDGene Study and then clinically validating these measures with echocardiography, cardiac MRI and measures of DLCO (Aim 3). In the final steps of Aim 3 we will examine the overlap and associations between pulmonary and cardiovascular disease (both clinical diagnosed CVD and both coronary and thoracic aortic calcification) and the relationship between pulmonary vascular morphology and exercise capacity, acute exacerbations of COPD, symptoms, and mortality. We believe that this will lead to improved understanding of the pathophysiology of COPD and may ultimately improve the care of patients with COPD.

Public Health Relevance

Computed tomographic assessments of pulmonary vascular morphology in subjects enrolled in the COPDGene Study may provide insight into the burden, severity, and clinical impact of pulmonary vascular remodeling in smokers. A deeper understanding of the types of remodeling present (narrowing, elongation, drop out) may lead to new therapies for patients with COPD.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
1R01HL116473-01
Application #
8418060
Study Section
Infectious Diseases, Reproductive Health, Asthma and Pulmonary Conditions Study Section (IRAP)
Program Officer
Peavy, Hannah H
Project Start
2013-02-01
Project End
2018-01-31
Budget Start
2013-02-01
Budget End
2014-01-31
Support Year
1
Fiscal Year
2013
Total Cost
$474,764
Indirect Cost
$207,600
Name
Brigham and Women's Hospital
Department
Type
DUNS #
030811269
City
Boston
State
MA
Country
United States
Zip Code
02115
Rahaghi, F N; Ross, J C; Agarwal, M et al. (2016) Pulmonary vascular morphology as an imaging biomarker in chronic thromboembolic pulmonary hypertension. Pulm Circ 6:70-81
Araki, Tetsuro; Nishino, Mizuki; Gao, Wei et al. (2016) Normal thymus in adults: appearance on CT and associations with age, sex, BMI and smoking. Eur Radiol 26:15-24
Wells, J Michael; Estepar, Raul San Jose; McDonald, Merry-Lynn N et al. (2016) Clinical, physiologic, and radiographic factors contributing to development of hypoxemia in moderate to severe COPD: a cohort study. BMC Pulm Med 16:169
Harmouche, Rola; Ross, James C; Diaz, Alejandro A et al. (2016) A Robust Emphysema Severity Measure Based on Disease Subtypes. Acad Radiol 23:421-8
Diaz, Alejandro A; Estépar, Raul San José; Washko, George R (2016) Computed Tomographic Airway Morphology in Chronic Obstructive Pulmonary Disease. Remodeling or Innate Anatomy? Ann Am Thorac Soc 13:4-9
Rahaghi, Farbod N; Wells, J Michael; Come, Carolyn E et al. (2016) Arterial and Venous Pulmonary Vascular Morphology and Their Relationship to Findings in Cardiac Magnetic Resonance Imaging in Smokers. J Comput Assist Tomogr 40:948-952
Kapur, Tina; Pieper, Steve; Fedorov, Andriy et al. (2016) Increasing the impact of medical image computing using community-based open-access hackathons: The NA-MIC and 3D Slicer experience. Med Image Anal 33:176-80
Jimenez-Carretero, Daniel; San Jose Estepar, Raul; Diaz Cacio, Mario et al. (2016) Automatic Synthesis of Anthropomorphic Pulmonary CT Phantoms. PLoS One 11:e0146060
Putman, Rachel K; Hatabu, Hiroto; Araki, Tetsuro et al. (2016) Association Between Interstitial Lung Abnormalities and All-Cause Mortality. JAMA 315:672-81
Ho, Jennifer E; Gao, Wei; Levy, Daniel et al. (2016) Galectin-3 Is Associated with Restrictive Lung Disease and Interstitial Lung Abnormalities. Am J Respir Crit Care Med 194:77-83

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