Pulmonary Arterial Enlargement and Acute Exacerbations of COPD

J Michael Wells; George R Washko; MeiLan K Han; Naseer Abbas; Hrudaya Nath; A James Mamary; Elizabeth Regan; William C Bailey; Fernando J Martinez; Elizabeth Westfall; Terri H Beaty; Douglas Curran-Everett; Jeffrey L Curtis; John E Hokanson; David A Lynch; Barry J Make; James D Crapo; Edwin K Silverman; Russell P Bowler; Mark T Dransfield; COPDGene Investigators; Edwin van Beek

doi:10.1056/NEJMoa1203830

Pulmonary Arterial Enlargement and Acute Exacerbations of COPD

J Michael Wells, George R Washko, MeiLan K Han, Naseer Abbas, Hrudaya Nath, A James Mamary, Elizabeth Regan, William C Bailey, Fernando J Martinez, Elizabeth Westfall, Terri H Beaty, Douglas Curran-Everett, Jeffrey L Curtis, John E Hokanson, David A Lynch, Barry J Make, James D Crapo, Edwin K Silverman, Russell P Bowler, Mark T DransfieldCOPDGene Investigators, Edwin van Beek

Research output: Contribution to journal › Article › peer-review

Abstract

Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with accelerated loss of lung function and death. Identification of patients at risk for these events, particularly those requiring hospitalization, is of major importance. Severe pulmonary hypertension is an important complication of advanced COPD and predicts acute exacerbations, though pulmonary vascular abnormalities also occur early in the course of the disease. We hypothesized that a computed tomographic (CT) metric of pulmonary vascular disease (pulmonary artery enlargement, as determined by a ratio of the diameter of the pulmonary artery to the diameter of the aorta [PA:A ratio] of >1) would be associated with severe COPD exacerbations.

Original language	English
Pages (from-to)	913-921
Number of pages	9
Journal	New England Journal of Medicine
Volume	367
Issue number	10
DOIs	https://doi.org/10.1056/NEJMoa1203830
Publication status	Published - 6 Sep 2012

Keywords

Acute Disease
Aged
Aorta
Aortography
Female
Humans
Logistic Models
Male
Middle Aged
Observation
Pulmonary Artery
Pulmonary Disease, Chronic Obstructive
Recurrence
Risk Factors
Smoking
Tomography, X-Ray Computed

Access to Document

10.1056/NEJMoa1203830

Pulmonary arterial enlargement and acute exacerbations of COPD
Published in final edited form as: N Engl J Med. 2012 September 6; 367(10): 913–921. Published online 2012 September 3. doi: 10.1056/NEJMoa1203830
Accepted author manuscript, 790 KB

http://www.nejm.org/doi/full/10.1056/NEJMoa1203830

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Wells, J. M., Washko, G. R., Han, M. K., Abbas, N., Nath, H., Mamary, A. J., Regan, E., Bailey, W. C., Martinez, F. J., Westfall, E., Beaty, T. H., Curran-Everett, D., Curtis, J. L., Hokanson, J. E., Lynch, D. A., Make, B. J., Crapo, J. D., Silverman, E. K., Bowler, R. P., ... van Beek, E. (2012). Pulmonary Arterial Enlargement and Acute Exacerbations of COPD. New England Journal of Medicine, 367(10), 913-921. https://doi.org/10.1056/NEJMoa1203830

Wells, J Michael ; Washko, George R ; Han, MeiLan K ; Abbas, Naseer ; Nath, Hrudaya ; Mamary, A James ; Regan, Elizabeth ; Bailey, William C ; Martinez, Fernando J ; Westfall, Elizabeth ; Beaty, Terri H ; Curran-Everett, Douglas ; Curtis, Jeffrey L ; Hokanson, John E ; Lynch, David A ; Make, Barry J ; Crapo, James D ; Silverman, Edwin K ; Bowler, Russell P ; Dransfield, Mark T ; COPDGene Investigators ; van Beek, Edwin. / Pulmonary Arterial Enlargement and Acute Exacerbations of COPD. In: New England Journal of Medicine. 2012 ; Vol. 367, No. 10. pp. 913-921.

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abstract = "Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with accelerated loss of lung function and death. Identification of patients at risk for these events, particularly those requiring hospitalization, is of major importance. Severe pulmonary hypertension is an important complication of advanced COPD and predicts acute exacerbations, though pulmonary vascular abnormalities also occur early in the course of the disease. We hypothesized that a computed tomographic (CT) metric of pulmonary vascular disease (pulmonary artery enlargement, as determined by a ratio of the diameter of the pulmonary artery to the diameter of the aorta [PA:A ratio] of >1) would be associated with severe COPD exacerbations.",

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Wells, JM, Washko, GR, Han, MK, Abbas, N, Nath, H, Mamary, AJ, Regan, E, Bailey, WC, Martinez, FJ, Westfall, E, Beaty, TH, Curran-Everett, D, Curtis, JL, Hokanson, JE, Lynch, DA, Make, BJ, Crapo, JD, Silverman, EK, Bowler, RP, Dransfield, MT, COPDGene Investigators & van Beek, E 2012, 'Pulmonary Arterial Enlargement and Acute Exacerbations of COPD', New England Journal of Medicine, vol. 367, no. 10, pp. 913-921. https://doi.org/10.1056/NEJMoa1203830

Pulmonary Arterial Enlargement and Acute Exacerbations of COPD. / Wells, J Michael; Washko, George R; Han, MeiLan K; Abbas, Naseer; Nath, Hrudaya; Mamary, A James; Regan, Elizabeth; Bailey, William C; Martinez, Fernando J; Westfall, Elizabeth; Beaty, Terri H; Curran-Everett, Douglas; Curtis, Jeffrey L; Hokanson, John E; Lynch, David A; Make, Barry J; Crapo, James D; Silverman, Edwin K; Bowler, Russell P; Dransfield, Mark T; COPDGene Investigators ; van Beek, Edwin (Member of Group Organisation).

In: New England Journal of Medicine, Vol. 367, No. 10, 06.09.2012, p. 913-921.

Research output: Contribution to journal › Article › peer-review

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T1 - Pulmonary Arterial Enlargement and Acute Exacerbations of COPD

AU - Wells, J Michael

AU - Washko, George R

AU - Han, MeiLan K

AU - Abbas, Naseer

AU - Nath, Hrudaya

AU - Mamary, A James

AU - Regan, Elizabeth

AU - Bailey, William C

AU - Martinez, Fernando J

AU - Westfall, Elizabeth

AU - Beaty, Terri H

AU - Curran-Everett, Douglas

AU - Curtis, Jeffrey L

AU - Hokanson, John E

AU - Lynch, David A

AU - Make, Barry J

AU - Crapo, James D

AU - Silverman, Edwin K

AU - Bowler, Russell P

AU - Dransfield, Mark T

AU - COPDGene Investigators

A2 - van Beek, Edwin

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N2 - Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with accelerated loss of lung function and death. Identification of patients at risk for these events, particularly those requiring hospitalization, is of major importance. Severe pulmonary hypertension is an important complication of advanced COPD and predicts acute exacerbations, though pulmonary vascular abnormalities also occur early in the course of the disease. We hypothesized that a computed tomographic (CT) metric of pulmonary vascular disease (pulmonary artery enlargement, as determined by a ratio of the diameter of the pulmonary artery to the diameter of the aorta [PA:A ratio] of >1) would be associated with severe COPD exacerbations.

AB - Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with accelerated loss of lung function and death. Identification of patients at risk for these events, particularly those requiring hospitalization, is of major importance. Severe pulmonary hypertension is an important complication of advanced COPD and predicts acute exacerbations, though pulmonary vascular abnormalities also occur early in the course of the disease. We hypothesized that a computed tomographic (CT) metric of pulmonary vascular disease (pulmonary artery enlargement, as determined by a ratio of the diameter of the pulmonary artery to the diameter of the aorta [PA:A ratio] of >1) would be associated with severe COPD exacerbations.

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KW - Aged

KW - Aorta

KW - Aortography

KW - Female

KW - Humans

KW - Logistic Models

KW - Male

KW - Middle Aged

KW - Observation

KW - Pulmonary Artery

KW - Pulmonary Disease, Chronic Obstructive

KW - Recurrence

KW - Risk Factors

KW - Smoking

KW - Tomography, X-Ray Computed

U2 - 10.1056/NEJMoa1203830

DO - 10.1056/NEJMoa1203830

M3 - Article

C2 - 22938715

VL - 367

SP - 913

EP - 921

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 0028-4793

IS - 10

ER -