Pulmonary blood volume indexed to lung volume is reduced in newly diagnosed systemic sclerosis compared to normals – a prospective clinical cardiovascular magnetic resonance study addressing pulmonary vascular changes

Journal of Cardiovascular Magnetic Resonance

Research

Martin Ugander¹  Mikael Kanski¹  Håkan Arheden¹  Gracijela Bozovic²  Roger Hesselstrand³  Dirk M Wuttge³ 

[1] Department of Clinical Physiology, Lund University and Lund University Hospital, Lund, SE-221 85, Lund, Sweden;Department of Radiology, Lund University and Lund University Hospital, Lund, SE-221 85, Lund, Sweden;Department of Rheumatology, Lund University and Lund University Hospital, Lund, SE-221 85, Lund, Sweden;

关键词: Cardiovascular Magnetic Resonance;    Pulmonary Arterial Hypertension;    Pulmonary Fibrosis;    Pulmonary Involvement;    Pulmonary Vasculature;   

DOI  :  10.1186/1532-429X-15-86

 received in 2011-06-15, accepted in 2013-09-11,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundPulmonary involvement, manifested as pulmonary arterial hypertension or pulmonary fibrosis, is the most common cause of death in systemic sclerosis (SSc). We aimed to explore the feasibility of detecting early pulmonary involvement in SSc using recently developed non-invasive quantitative measures of pulmonary physiology using cardiovascular magnetic resonance (CMR).MethodsTwenty-seven SSc patients (9 men, 57 ± 13 years) and 10 healthy controls (3 men, 54 ± 9 years) underwent CMR to determine the pulmonary blood volume (PBV) and the PBV variation (PBVV) throughout the cardiac cycle. Patients underwent Doppler echocardiography, high-resolution computed tomography (HRCT), and pulmonary function testing by spirometry. Comparisons were performed using the unpaired t-test and linear regression analysis was performed with Pearson’s correlation coefficient (r).ResultsCompared to healthy controls, the PBV indexed to lung volume (PBVI) was lower in patients (16 ± 4 vs 20 ± 5%, p < 0.05). There was no difference in PBV (466 ± 87 vs 471 ± 122 mL, p = 0.91) or PBVV/stroke volume (45 ± 10 vs 40 ± 6%, p = 0.09). There were no significant correlations between PBVI and pulmonary artery pressure estimated by Doppler (p = 0.08) the lung’s diffusion capacity for carbon monoxide (DLCO) (p = 0.09), vital capacity (p = 0.45), or pulmonary fibrosis by HRCT (p = 0.74).ConclusionsThis study is the first to measure the PBV in humans using CMR. Compared to healthy controls, newly diagnosed SSc patients have a reduced amount of blood in the pulmonary vasculature (PBVI) but unchanged pulmonary vascular distensibility (PBVV/stroke volume). PBVI is unrelated to DLCO, pulmonary artery pressure, vital capacity, and the presence of pulmonary fibrosis. PBVI may be a novel parameter reflecting vascular lung involvement in early-stage SSc, and these findings may be consistent with pathophysiological changes of the pulmonary vasculature.

【 授权许可】

Unknown   
© Kanski et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.