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J Thorac Dis. 2016 Jul;8(7):1524-31. doi: 10.21037/jtd.2016.05.79.

Implications of the pulmonary artery to ascending aortic ratio in patients with relatively mild chronic obstructive pulmonary disease.

Author information

1
Department of School of Medicine, Kangwon National University, Chuncheon, Korea ;
2
Department of Respiratory Center, Kangwon National University Hospital, Chuncheon, Korea ;
3
Department of Radiology, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea ;
4
Stem Cell Institute, Kangwon National University, Chuncheon, Korea ;
5
Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea.

Abstract

BACKGROUND:

Identifying markers for predicting the course and outcome of chronic obstructive pulmonary disease (COPD) remains important. The relative pulmonary artery enlargement to aorta ratio (PA-A ratio), which is measured using computed tomography (CT), is a reported predictor for COPD exacerbation and mortality. However, little is known about the implications of the PA-A ratio in patients with mild COPD.

METHODS:

We investigated the utility of the PA-A ratio as a biomarker in patients with relatively mild COPD. A total of 131 patients with mild to moderate COPD [post-bronchodilator forced expiratory volume in 1 sec (FEV1)/forced vital capacity (FVC) 61.6±6.4, mean post-bronchodilator FEV1 83%±17.8% of predicted value] were selected from a Korean COPD cohort (from 2012 until the end of 2014) and analyzed retrospectively. We determined the correlation between the PA-A ratio and clinical parameters using a linear regression model.

RESULTS:

The COPD assessment test (P=0.04), FEV1 (P=0.03), and a history of exacerbation in the last year (P=0.03) were significant factors in the univariate linear regression analysis. Post-bronchodilator FEV1 was most significantly associated with the PA-A ratio in the multivariate analysis (P=0.01).

CONCLUSIONS:

The PA-A ratio evaluated by CT imaging was independently correlated with a representative pulmonary function factor (FEV1) in patients with relatively mild COPD. The results suggest that the PA-A ratio may be an important biomarker for clinical outcome in patients with mild COPD.

KEYWORDS:

Biomarker; chronic obstructive lung disease (COPD); computed tomography (CT); exacerbation; relative pulmonary artery to aorta ratio (PA-A ratio)

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