Pulmonary Arterial Histologic Lesions in Patients With COPD With Severe Pulmonary Hypertension
| Autor: | Marc Humbert, Yves Castier, Alice Guyard, David Montani, Peter Dorfmüller, Hervé Mal, G. Dauriat, Gabriel Thabut, Clément Gauvain, Claire Danel, Vincent Bunel |
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| Přispěvatelé: | Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Hypertension pulmonaire : physiopathologie et innovation thérapeutique (HPPIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay |
| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty medicine.medical_treatment [SDV]Life Sciences [q-bio] Hypertension Pulmonary Cardiac index Pulmonary Artery Critical Care and Intensive Care Medicine Severity of Illness Index 03 medical and health sciences Pulmonary Disease Chronic Obstructive 0302 clinical medicine DLCO Internal medicine medicine Lung transplantation Humans Lung volumes 030212 general & internal medicine Pulmonary wedge pressure Retrospective Studies COPD business.industry Microcirculation Airway obstruction Middle Aged medicine.disease Pulmonary hypertension respiratory tract diseases 3. Good health 030228 respiratory system Cardiology Female Cardiology and Cardiovascular Medicine business Lung Transplantation |
| Zdroj: | Chest Chest, American College of Chest Physicians, 2019, 156, pp.33-44. ⟨10.1016/j.chest.2019.02.333⟩ |
| ISSN: | 1931-3543 0012-3692 |
| DOI: | 10.1016/j.chest.2019.02.333⟩ |
| Popis: | The development of pulmonary hypertension (PH) during the course of COPD is a well-known phenomenon, with the prevalence depending on the severity of airway obstruction. When mean pulmonary pressure (mPAP) level at rest is ≥ 35 mm Hg or ≥ 25 mm Hg with low cardiac index, the term severe PH is used. For these patients, little is known on the underlying histologic lesions. Our objective was to describe these lesions.From the explants of patients undergoing lung transplantation, we compared retrospectively three groups of patients with COPD: severe PH-COPD (n = 10), moderate PH-COPD (mPAP between 25 and 34 mm Hg without low cardiac index) (n = 10), and no PH (mPAP 25 mm Hg) (n = 10). Histologic analysis of the explanted lungs examined the wall of medium-size arteries, the remodeling of microvessels, and the pulmonary capillary density using morphometric measurements performed on three sections per patient.Compared with the moderate PH group, the remodeling score of the microvessels was significantly higher (P = .0045) and the capillary density was lower (P = .0049) in the severe PH-COPD group. The alterations of the medium-size arteries, important in group 1 PH, seemed less discriminating.Patients with severe PH-COPD appear to have a specific histologic pattern, different from that observed in patients with COPD with moderate PH or without PH. |
| Databáze: | OpenAIRE |
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