Quantitative Assessment Characteristics of Small Pulmonary Vessel Remodelling in Populations at High Risk for COPD and Smokers Using Low-Dose CT

Abstract

Purpose

To explore the morphological alterations in small pulmonary vessels in populations at high risk for chronic obstructive pulmonary disease (COPD) and smokers based on multiple computed tomography (CT) quantitative parameters.

Patients and Methods

A total of 1969 Three Major Chest Diseases Screening Study participants with available demographic data and smoking history who underwent low-dose chest CT from 2018 to 2020 were included. All subjects were divided into normal, high risk for COPD, and COPD groups according to their pulmonary function test (PFT) results. Furthermore, the three groups were further subdivided into never-smokers, current smokers, and former smokers subgroups according to their smoking history. Quantitative parameters, such as the number, area at 6 mm~24 mm subpleura and volume of small pulmonary vessels, were extracted by computer software. Differences in small pulmonary vessel parameters among the groups were compared using two-way ANOVA.

Results

The number, area at 6 mm~24 mm subpleura and volume of small pulmonary vessels in the group at high risk for COPD were lower than those in the normal group (P<0.05). The number, area at 6 mm~24 mm subpleura and volume of small pulmonary vessels in the COPD group were higher than those in the normal group (P<0.05). The number, area of small pulmonary vessels at 6 mm~12 mm subpleura in current smokers with high risk for COPD were higher than those in former smokers with high risk for COPD (P<0.05).

Conclusion

The number, area, and volume of small pulmonary vessels in populations at high risk for COPD were decreased. Smoking cessation may impede structural changes in small pulmonary vessels in populations at high risk for COPD.

Keywords:

• chronic obstructive pulmonary disease
• computed tomography
• pulmonary vascular structure
• quantitative analysis
• smoking

Abbreviations

COPD, chronic obstructive pulmonary disease; CT, computed tomography; PFT, pulmonary function test; GOLD, Global Initiative for Chronic Obstructive Lung Disease; FEV1% pre, FEV1% predicted value; No. Vessels, number of small pulmonary vessels; No. Vessels CSA< 5mm², numbers of pulmonary vessels with a cross-sectional area less than 5 mm²; Surface Area of LAA, surface area of low-attenuating-areas below −950 HU; Vessel Area, area of small pulmonary vessels; Total Vessel Surface Area, total surface area of small pulmonary vessels; LV, lung volume; TBV, total blood volume; BV1, blood vessel volume in vessels with a cross-sectional area less than 1mm²; BV5, blood vessel volume in vessels with a cross-sectional area less than 5mm².

Data Sharing Statement

The data will be available from the corresponding author on reasonable request.

Consent for Publication

The authors confirm that all the contents in this review can be published.

Acknowledgments

We greatly appreciate Ms. Qian He (Department of Statistics, Naval Medical University, Shanghai, China) for her assistance in statistical analysis.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China (grant numbers: 82171926, 81930049); National Key R&D Program of China (grant number: 2022YFC2010000, 2022YFC2010002, 2022YFC2010005); the program of Science and Technology Commission of Shanghai Municipality (grant number 21DZ2202600); the construction of CT standardized database for chronic obstructive pulmonary disease (grant number: YXFSC2022JJSJ002); Clinical Innovation Project of Shanghai Changzheng Hospital (grant number: 2020YLCYJ-Y24).