Abstract:
BACKGROUND:COPD is associated with significant morbidity primarily driven by acute exacerbations. Relative pulmonary artery (PA) enlargement, defined as a PA to ascending aorta (A) diameter ratio greater than one (PA:A>1) identifies patients at increased risk for exacerbations. However, little is known about the correlation between PA:A, echocardiography, and invasive hemodynamics in COPD. METHODS:A retrospective observational study of patients with severe COPD being evaluated for lung transplantation at a single center between 2007 and 2011 was conducted. Clinical characteristics, CT scans, echocardiograms, and right-sided heart catheterizations were reviewed. The PA diameter at the bifurcation and A diameter from the same CT image were measured. Linear and logistic regression were used to examine the relationships between PA:A ratio by CT scan and PA systolic pressure (PASP) by echocardiogram with invasive hemodynamics. Receiver operating characteristic analysis assessed the usefulness of the PA:A ratio and PASP in predicting resting pulmonary hypertension (PH) (mean pulmonary artery pressure [mPAP]>25 mm Hg). RESULTS:Sixty patients with a mean predicted FEV1 of 27%±12% were evaluated. CT scan-measured PA:A correlated linearly with mPAP after adjustment for multiple covariates (r=0.30, P=.03), a finding not observed with PASP. In a multivariate logistic model, mPAP was independently associated with PA:A>1 (OR, 1.44; 95% CI, 1.02-2.04; P=.04). PA:A>1 was 73% sensitive and 84% specific for identifying patients with resting PH (area under the curve, 0.83; 95% CI, 0.72-0.93; P<.001), whereas PASP was not useful. CONCLUSIONS:A PA:A ratio>1 on CT scan outperforms echocardiography for diagnosing resting PH in patients with severe COPD.
journal_name
Chestjournal_title
Chestauthors
Iyer AS,Wells JM,Vishin S,Bhatt SP,Wille KM,Dransfield MTdoi
10.1378/chest.13-1422subject
Has Abstractpub_date
2014-04-01 00:00:00pages
824-832issue
4eissn
0012-3692issn
1931-3543pii
S0012-3692(15)35953-5journal_volume
145pub_type
杂志文章相关文献
CHEST文献大全abstract::The authors believe this to be the first case report of atrial fibrillation following pulse methylprednisolone therapy in an adult. The literature regarding the complications of pulse methylprednisolone therapy is reviewed, with particular emphasis on the incidence and pathogenesis of arrhythmias. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.104.2.622
更新日期:1993-08-01 00:00:00
abstract:STUDY OBJECTIVES:To validate a previously developed multisystem organ failure (MSOF) score with and without the addition of the lactate dehydrogenase (LDH) level as a predictor of survival to hospital discharge in patients with AIDS-related Pneumocystis carinii pneumonia (PCP) and acute respiratory failure (ARF). DESI...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.114.1.199
更新日期:1998-07-01 00:00:00
abstract::To predict the postoperative improvement in performance status after bullectomy, preoperative pulmonary function and dyspneic grade were evaluated in 20 patients with giant bulla. The patients were divided into two groups, based on postoperative performance status: group 1 consisted of 15 patients with improved status...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.101.3.668
更新日期:1992-03-01 00:00:00
abstract::To assess the role of open lung biopsy in patients with the acquired immunodeficiency syndrome (AIDS), we retrospectively reviewed the cases of 42 patients with AIDS who underwent this procedure for the diagnosis of pulmonary infiltrates. Four patients had no preceding bronchoscopy because the severity of the respirat...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.91.5.659
更新日期:1987-05-01 00:00:00
abstract::Ozone can cause pulmonary edema and simultaneously decrease blood pressure. Atrial natriuretic factor (ANF) may mediate both of these effects in that it increases pulmonary capillary permeability resulting in edema formation and vasodilates the vascular system. The present investigation was designed to test directly t...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.105.5.1551
更新日期:1994-05-01 00:00:00
abstract::The therapeutic effects of cuirass ventilation were studied in two patients with bilateral diaphragm paralysis. Negative inspiratory and positive expiratory pressure applied to the cuirass shell was transmitted to the abdominal and thoracic cavities. Diaphragm excursion was enhanced. Nocturnal cuirass ventilation appe...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.92.4.683
更新日期:1987-10-01 00:00:00
abstract:STUDY OBJECTIVE:Determine reintubation rate, identify its cause, and detail adverse outcomes from reintubation. DESIGN:Retrospective review of extubation failures in the trauma ICU. SETTING:University hospital and regional trauma center. PATIENTS:Four hundred five patients arriving intubated or requiring intubation ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.110.6.1577
更新日期:1996-12-01 00:00:00
abstract::99mTechnetium stannous pyrophosphate has been shown to accumulate in acutely infarcted myocardium. To determine if the isotope is also taken up by severely ischemic, but not necrotic myocardium, we performed myocardial scintigraphic studies in 17 patients with chest pains. Seven of the patients satisfied conventional ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.69.2.168
更新日期:1976-02-01 00:00:00
abstract::Nineteen consecutive patients with clinically suspected sarcoidosis underwent 67Ga-scintigraphy prior to transbronchial lung biopsy (TBLB) to determine if 67Ga uptake in lung parenchyma would increase the diagnostic yield of the biopsy procedure. Biopsies were obtained from the areas showing parenchymal uptake on the ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.82.1.7
更新日期:1982-07-01 00:00:00
abstract::In a double-blind, crossover study, nebulized ketanserin, a 5-HT2 receptor antagonist, and a placebo were given to eight patients with moderate to severe nonasthmatic COPD. Intravenous ketanserin had rapid onset of action and induced a longer lasting bronchial response than inhaled ketanserin. These results confirm th...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.97.4.901
更新日期:1990-04-01 00:00:00
abstract::A renewed interest in the clinical and pathogenic aspects of COPD exacerbation is timely in view of national and global COPD initiatives. The three big problems regarding COPD continue to be the following: prevention of the disease; slowing progression of the disease once diagnosis has been established; and prevention...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.117.5_suppl_2.376s
更新日期:2000-05-01 00:00:00
abstract::Previously, we have reported in 1990 that 35% of carmustine treated patients (6 of 17) who survived childhood brain tumors died of pulmonary fibrosis between 2 and 13 years after treatment. In addition, 8 patients studied in 1989 (13 to 17 years post treatment), had physiologic and biopsy or radiologic evidence of pul...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.107.5.1355
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:FEV1 may remain stable while high-resolution CT (HRCT) appearances deteriorate in children with cystic fibrosis (CF). However, spirometry results commonly decline in older age groups. OBJECTIVES:To compare the rate of decline in HRCT abnormalities and spirometry results over time in an adult cohort with CF....
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.130.5.1424
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:There is increasing support for the use of noninvasive positive pressure ventilation (NPPV) in the treatment of patients with acute respiratory failure. Highest success rates are recorded in patients with exacerbation of COPD, particularly in patients presenting primarily with hypercarbic respiratory failure...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.115.1.173
更新日期:1999-01-01 00:00:00
abstract::Cross-sectional echocardiography (CSE) was performed on 19 patients with mitral stenosis (MS). Nine patients (group 1) had little or no mitral valve (MV) calcification; ten patients (group 2) had heavy MV calcification. An opening snap was present in each of the patients in group 1. Of the group 2 patients, five (grou...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.78.6.822
更新日期:1980-12-01 00:00:00
abstract::We studied six patients with type A botulism to determine the degree of initial respiratory compromise and to quantitate the time course and extent of recovery of the ventilatory and upper airway muscles and exercise performance. The VM weakness was identified in all patients early after botulism. Upper airway muscle ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.98.3.620
更新日期:1990-09-01 00:00:00
abstract::The literature on pulmonary function testing in sarcoidosis is critically reviewed. The results indicate that pulmonary function tests are not a reliable means for detecting the presence of parenchymal sarcoidosis, nor do they provide an accurate estimate of the extent of parenchymal disease. There are at present no k...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.78.4.640
更新日期:1980-10-01 00:00:00
abstract::The "elimination" of the left atrial appendage (LAA) seems to be an attractive alternative to oral anticoagulation in the treatment of atrial fibrillation, especially in patients with contraindications to oral anticoagulation therapy. The LAA, however, plays an important role in the maintenance and regulation of the c...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.124.6.2356
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:Chronic rhinosinusitis (CRS) has been reported to be associated with increased values of exhaled nitric oxide (ENO), which could not be entirely explained by the association between CRS and asthma. The aim of this study was to investigate the variables associated with increased ENO in patients with CRS. MET...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.09-0667
更新日期:2010-03-01 00:00:00
abstract::We analyzed seven patients with beta-thalassemia intermedia presenting with congestive heart failure secondary to pulmonary hypertension. This condition has been recognized only recently as part of the clinical spectrum of beta-thalassemia. Our group of patients included two men and five women with the clinical pictur...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.107.1.50
更新日期:1995-01-01 00:00:00
abstract::We report 4 cases of Churg-Strauss syndrome (CSS) that occurred in patients being treated with corticosteroids for a diagnosis of asthma. One patient had asthma, eosinophilia, and eosinophilic lymphadenopathy that regressed with higher doses of corticosteroids. The second patient had both eosinophilic tissue infiltrat...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.108.2.320
更新日期:1995-08-01 00:00:00
abstract:BACKGROUND:Current management guidelines for pulmonary arterial hypertension (PAH) recommend a treatment choice based primarily on World Health Organization (WHO) functional class. This study was designed to assess how the incorporation of readily obtained clinical and test-based information may significantly improve t...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.10-1293
更新日期:2011-06-01 00:00:00
abstract::This study was designed to determine if there is residual airflow obstruction and/or airway hyperresponsiveness in adults with symptomatic asthma remission, and if age at remission or its duration influence these parameters. We studied 30 subjects, (20 men, 10 women, 28 atopics, aged 18 to 61 years; mean, 32 years) wi...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.105.4.1024
更新日期:1994-04-01 00:00:00
abstract:STUDY OBJECTIVES:To develop a simplified prognostic prediction rule for patients admitted to ICUs for severe community-acquired pneumonia (CAP). SETTING:Six ICUs in the north of France. PATIENTS:Five hundred five patients admitted to ICUs over a 9-year period (from 1987 to 1995) for severe CAP. INTERVENTIONS:Retrosp...
journal_title:Chest
pub_type: 杂志文章,多中心研究
doi:10.1378/chest.116.1.157
更新日期:1999-07-01 00:00:00
abstract::Childhood sleep-disordered breathing (SDB) has been known to be associated with health and cognitive impacts for more than a century, and yet our understanding of this disorder is in its infancy. Neuropsychological consequences in children with snoring or subtle breathing disturbances not meeting the traditional defin...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.06-2827
更新日期:2007-12-01 00:00:00
abstract:CASE PRESENTATION:A 62-year-old woman with a history of partially treated Graves disease and hypertension presented with approximately 3 weeks of worsening fatigue, lower extremity myalgias, and shortness of breath. Her medical history included a thyroid radiofrequency ablation several years earlier. Following the abla...
journal_title:Chest
pub_type:
doi:10.1016/j.chest.2019.09.041
更新日期:2020-03-01 00:00:00
abstract:STUDY OBJECTIVES:Small-cell lung cancer (SCLC) has an unfavorable prognosis, especially when the disease is extensive at presentation. Accurate staging procedures are therefore needed for treatment planning. Positron emission tomography (PET) is a modern noninvasive imaging technique, the value of which for the staging...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.119.3.950
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Pulmonary vascular capacitance (PVC) is reduced in pulmonary arterial hypertension (PAH). In normal lung, PVC is largely a function of vascular compliance. In PAH, increased pulmonary vascular resistance (PVR) arises from the arterioles. PVR and PVC share pressure and volume variables. The dependency between...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.14-1461
更新日期:2015-04-01 00:00:00
abstract::Brain natriuretic peptide (BNP), also called B-type natriuretic peptide, is a member of a family of structurally related hormones, the natriuretic peptides. Current data suggest that measurement of BNP plasma concentrations is a useful tool in the diagnosis of acute heart failure in patients presenting to an emergency...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.125.2.652
更新日期:2004-02-01 00:00:00
abstract::Ten patients undergoing pneumonectomy were evaluated with the lateral position test (LPT) in addition to routine pulmonary function tests (PFTs). On the basis of the percentage of ventilation estimated to be contributed by each lung on LPT, predictions were made for expected values for each patient's post-pneumonectom...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.77.1.24
更新日期:1980-01-01 00:00:00