Dataset Information

FVC/D_LCO identifies pulmonary hypertension and predicts 5-year all-cause mortality in patients with COPD.

ABSTRACT:

Background

Pulmonary hypertension (PH) is a common complication of chronic obstructive pulmonary disease (COPD). However, it is unknown whether the ratio of forced vital capacity (FVC) to diffusing lung capacity for carbon monoxide (D_LCO) can identify PH in the patients with COPD and predict its prognosis.

Methods

The study population I included 937 COPD patients who were admitted to inpatient treatments from 2010 to 2017, and finally 750 patients were available to follow-up the 5-year all-cause mortality (study population II). Clinical characteristics of the study population were recorded.

Results

COPD patients with PH had a higher FVC/D_LCO value compared with the patients without PH. The threshold for FVC/D_LCO to identify PH in COPD patients was 0.44 l/mmol/min/kPa. Multivariate logistic regression analysis showed that FVC/D_LCO was a significant predictor for PH in the patients with COPD. The study population II showed that the 5-year all-cause mortality of COPD patients was significantly higher in combined with PH group than without PH group. Compared with the survivor group, FVC/D_LCO value was significantly increased in non-survivor group. The threshold for FVC/D_LCO to predict 5-year all-cause mortality was 0.41 l/mmol/min/kPa. Kaplan-Meier survival curves showed that 5-year cumulative survival rate for COPD patients were significantly decreased when the value of FVC/D_LCO was ≥ 0.41 l/mmol/min/kPa. Multivariate cox regression analysis showed that FVC/D_LCO was an independent prognostic factor for 5-year all-cause mortality in COPD patients.

Conclusion

FVC/D_LCO could identify PH in the patients with COPD and was an independent predictor for 5-year all-cause mortality of COPD.

SUBMITTER: Li Y

PROVIDER: S-EPMC10184375 | biostudies-literature | 2023 May

REPOSITORIES: biostudies-literature

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Publications

FVC/D<sub>LCO</sub> identifies pulmonary hypertension and predicts 5-year all-cause mortality in patients with COPD.

Li Yuer Y Zhang Rui R Shan Hu H Shi Wenhua W Feng Xiaoli X Chen Haijuan H Yang Xia X Li Yali Y Zhang Jie J Zhang Ming M

European journal of medical research 20230515 1

<h4>Background</h4>Pulmonary hypertension (PH) is a common complication of chronic obstructive pulmonary disease (COPD). However, it is unknown whether the ratio of forced vital capacity (FVC) to diffusing lung capacity for carbon monoxide (D<sub>LCO</sub>) can identify PH in the patients with COPD and predict its prognosis.<h4>Methods</h4>The study population I included 937 COPD patients who were admitted to inpatient treatments from 2010 to 2017, and finally 750 patients were available to foll ...[more]

PMID: 37183240

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Project description:Pulmonary vascular arterial remodeling is an integral and well-understood component of pulmonary hypertension (PH). In contrast, morphological alterations of pulmonary veins in PH are scarcely described. Explanted lungs (n = 101) from transplant recipients with advanced chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary arterial hypertension (IPAH) were analyzed for venous vascular involvement according to a pre-specified, semi-quantitative grading scheme, which categorizes the intensity of venous remodeling in three groups of incremental severity: venous hypertensive (VH) grade 0 = characterized by an absence of venous vascular remodeling; VH grade 1 = defined by a dominance of either arterialization or intimal fibrosis; and VH grade 2 = a substantial composite of arterialization and intimal fibrosis. Patients were grouped according to clinical and hemodynamic characteristics in three groups: COPD non-PH, COPD-PH, and IPAH, respectively. Histological specimens were examined by a cardiovascular pathologist blinded to clinical and hemodynamic data. Pathological alterations of pulmonary veins were present in all hemodynamic groups, with the following incidences of VH grade 0/1/2: 34/66/0% in COPD non-PH; 19/71/10% in COPD-PH; and 11/61/28% in IPAH. In COPD, explorative correlation analysis of venous remodeling suggested a modest positive correlation with systolic and mean pulmonary artery pressure ( P = 0.032, respectively) and an inverse modest correlation with diffusion capacity for carbon monoxide ( P = 0.027). In addition, venous remodeling correlated positively with the degree of arterial remodeling ( P = 0.014). In COPD-PH and IPAH, advanced forms of pulmonary venous remodeling are present, emphasizing that the disease is not exclusively restricted to arterial lesions. In addition, venous remodeling may be related to the hemodynamic severity, but more rigorous analysis is required to clearly define potential relationships.

Project description:BackgroundThe ratio of the forced expiratory volume in 1 s (FEV1) to the forced vital capacity (FVC) is an essential tool for the diagnosis of chronic obstructive pulmonary disease (COPD). However, the relationship between levels of FEV1/FVC and mortality in the general population remains unclear, particularly its non-linear relationship. Therefore, we aimed to explore the association between the FEV1/FVC and all-cause mortality in the general population.MethodsThe data of participants included in the National Health and Nutrition Examination Survey (1988-1994 and 2007-2012 cycles) were analyzed. Participants aged ≥20 years, who were not pregnant, who underwent quality-controlled lung function tests, and with follow-up data on mortality status were enrolled. The study outcome was all-cause mortality. The participants were grouped by FEV1/FVC ratio in 0.10 increments. Cox proportional-hazards models were used to estimate the association between the FEV1/FVC ratio and all-cause mortality before and after confounder adjustment. Non-linear associations were explored using restricted cubic spline curves.ResultsOverall, 25,501 participants were included. During the median follow up of 308 months, 6431 (25.2%) deaths were recorded. Among all participants, the mean age is 46.3 years, and 48.7% of which were male. In unadjusted model, individuals with an FEV1/FVC ratio < 0.90 had an increased risk of all-cause mortality compared to those with an FEV1/FVC ratio ≥ 0.90. After adjusting for age, sex, body mass index, race, and smoking status, participants in the 0.60 ≤ FEV1/FVC < 0.90 group had a lower all-cause mortality risk than those in the FEV1/FVC ≥ 0.90 group, while the mortality risk of individuals with an FEV1/FVC ratio < 0.50 was higher. Restricted cubic splines revealed a U-shaped association between the FEV1/FVC ratio and all-cause mortality. Below and above the inflection point, an inverse trend was observed.ConclusionOur study first revealed a U-shaped association between the level of FEV1/FVC and all-cause mortality in general population.Clinical trial numberNot applicable.

Project description:BackgroundDespite causing increased morbidity and mortality, pulmonary hypertension (PH) in chronic obstructive pulmonary disease (COPD) patients (COPD-PH) lacks treatment, due to incomplete understanding of its pathogenesis. Hypertrophy of pulmonary arterial walls and pruning of the microvasculature with loss of capillary beds are known features of pulmonary vascular remodeling in COPD. The remodeling features of pulmonary medium- and smaller vessels in COPD-PH lungs are less well described and may be linked to maladaptation of endothelial cells to chronic cigarette smoking (CS). MicroRNA-126 (miR126), a master regulator of endothelial cell fate, has divergent functions that are vessel-size specific, supporting the survival of large vessel endothelial cells and inhibiting the proliferation of microvascular endothelial cells. Since CS decreases miR126 in microvascular lung endothelial cells, we set out to characterize the remodeling by pulmonary vascular size in COPD-PH and its relationship with miR126 in COPD and COPD-PH lungs.MethodsDeidentified lung tissue was obtained from individuals with COPD with and without PH and from non-diseased non-smokers and smokers. Pulmonary artery remodeling was assessed by ⍺-smooth muscle actin (SMA) abundance via immunohistochemistry and analyzed by pulmonary artery size. miR126 and miR126-target abundance were quantified by qPCR. The expression levels of ceramide, ADAM9, and endothelial cell marker CD31 were assessed by immunofluorescence.ResultsPulmonary arteries from COPD and COPD-PH lungs had significantly increased SMA abundance compared to non-COPD lungs, especially in small pulmonary arteries and the lung microvasculature. This was accompanied by significantly fewer endothelial cell markers and increased pro-apoptotic ceramide abundance. miR126 expression was significantly decreased in lungs of COPD individuals. Of the targets tested (SPRED1, VEGF, LAT1, ADAM9), lung miR126 most significantly inversely correlated with ADAM9 expression. Compared to controls, ADAM9 was significantly increased in COPD and COPD-PH lungs, predominantly in small pulmonary arteries and lung microvasculature.ConclusionBoth COPD and COPD-PH lungs exhibited significant remodeling of the pulmonary vascular bed of small and microvascular size, suggesting these changes may occur before or independent of the clinical development of PH. Decreased miR126 expression with reciprocal increase in ADAM9 may regulate endothelial cell survival and vascular remodeling in small pulmonary arteries and lung microvasculature in COPD and COPD-PH.

Dataset Information

FVC/D_LCO identifies pulmonary hypertension and predicts 5-year all-cause mortality in patients with COPD.

Background

Methods

Results

Conclusion

Publications

FVC/D<sub>LCO</sub> identifies pulmonary hypertension and predicts 5-year all-cause mortality in patients with COPD.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

FVC/DLCO identifies pulmonary hypertension and predicts 5-year all-cause mortality in patients with COPD.

Background

Methods

Results

Conclusion

Publications

FVC/D<sub>LCO</sub> identifies pulmonary hypertension and predicts 5-year all-cause mortality in patients with COPD.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

FVC/D_LCO identifies pulmonary hypertension and predicts 5-year all-cause mortality in patients with COPD.