Cardiac alterations related to new CT emphysema subtypes: results from the SubPopulations and InteRmediate Outcome Measures In COPD and Heart Failure Study (SPIROMICS HF)

<bold>Background:</bold> Chronic obstructive pulmonary disease (COPD) and heart failure often overlap clinically. We tested if new emphysema subtypes defined by unsupervised machine learning on computed tomography (CT) were associated with specific cardiac alterations. <bold>Methods:</bold> SPIROMICS HF is a multicenter observational study of cardiopulmonary interactions among smokers with >20 packyears and controls. This preliminary report explored associations between the 2 main CT emphysema subtypes in SPIROMICS, the combined bronchitic-apical emphysema (CBaE) and diffuse emphysema subtypes, and cardiac size and function, assessed on echocardiography and cardiac MRIs. Results were adjusted for demographics, height, weight, smoking, recruitment strata and other CT emphysema subtypes. <bold>Results:</bold> Among 529 participants (mean age 68 years, 52% male, 30% currently smoking, mean packyears 44.9 and 61.1% with COPD), CBeE and diffuse emphysema were labelled in 14.6% and 29.2% of the lung, respectively. Degree of CBaE was associated with higher pulmonary artery systolic pressure (PASP) (1.7 mmHg/10%; 95% CI 0.5-2.9; P=0.006) and greater right/left ventricle (LV) mass ratio (0.01/10%, 0.00-0.02, P=0.02) without a difference in LV stroke volume (P=0.54). Degree of diffuse emphysema was associated with lower LV stroke volume (−4.3 ml/10%; -6.3, -2.2; P<0.001) without a difference in PASP (P=0.24). <bold>Conclusion:</bold> Of the two main CT-defined emphysema subtypes, one was associated with greater PASP and evidence for cor pulmonale whereas the other was associated with lower LV function, findings reminiscent of the classic blue bloater and pink puffer COPD subtypes.

Authors

Institutions

Publication Details

Published
2024-09-14
DOI
https://doi.org/10.1183/13993003.congress-2024.pa3390
Primary Topic
Chronic Obstructive Pulmonary Disease (COPD) Research
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Cardiac alterations related to new CT emphysema subtypes: results from the SubPopulations and InteRmediate Outcome Measures In COPD and Heart Failure Study (SPIROMICS HF)

Jeff Hsu, Dipayan Chaudhuri, Joyce Schroeder, Abraham Theodore et al.
Chronic Obstructive Pulmonary Disease (COPD) Research
article

Cardiac alterations related to new CT emphysema subtypes: results from the SubPopulations and InteRmediate Outcome Measures In COPD and Heart Failure Study (SPIROMICS HF)

Jeff Hsu, Dipayan Chaudhuri, Joyce Schroeder, Abraham Theodore, Igor Barjaktarević, Troy LaBounty, James Carr, Artur Wysoczanski, Wei Shen, Garima Arora, R. Graham Barr, Daniel Shepshelovich, Martin R. Prince, João A.C. Lima, Steven G. Lloyd, Prachi Agarwal, Stephen P. Peters, Jing Liu, Karol Watson, Yi-Fei Sun, Dalane W. Kitzman, Jil Ohar, Aparna Balasubramanian, Emilia A. Hermann, Bharath Ambale‐Venkatesh, Nadia Hansel, Prescott G. Woodruff, Jerry A. Krishnan, Benjamin H. Freed, Mark Dransfield, Jens Vogel‐Claussen, David Couper, Andrew F. Laine, Yoo Jin Lee, Meilan Han, Victor E. Ortega, C.B. Cooper, Sanjiv J. Shah, Robert Paine, Paul Finn, Elsa Angelinini, Bluemke David A
article en

Abstract

<bold>Background:</bold> Chronic obstructive pulmonary disease (COPD) and heart failure often overlap clinically. We tested if new emphysema subtypes defined by unsupervised machine learning on computed tomography (CT) were associated with specific cardiac alterations. <bold>Methods:</bold> SPIROMICS HF is a multicenter observational study of cardiopulmonary interactions among smokers with >20 packyears and controls. This preliminary report explored associations between the 2 main CT emphysema subtypes in SPIROMICS, the combined bronchitic-apical emphysema (CBaE) and diffuse emphysema subtypes, and cardiac size and function, assessed on echocardiography and cardiac MRIs. Results were adjusted for demographics, height, weight, smoking, recruitment strata and other CT emphysema subtypes. <bold>Results:</bold> Among 529 participants (mean age 68 years, 52% male, 30% currently smoking, mean packyears 44.9 and 61.1% with COPD), CBeE and diffuse emphysema were labelled in 14.6% and 29.2% of the lung, respectively. Degree of CBaE was associated with higher pulmonary artery systolic pressure (PASP) (1.7 mmHg/10%; 95% CI 0.5-2.9; P=0.006) and greater right/left ventricle (LV) mass ratio (0.01/10%, 0.00-0.02, P=0.02) without a difference in LV stroke volume (P=0.54). Degree of diffuse emphysema was associated with lower LV stroke volume (−4.3 ml/10%; -6.3, -2.2; P<0.001) without a difference in PASP (P=0.24). <bold>Conclusion:</bold> Of the two main CT-defined emphysema subtypes, one was associated with greater PASP and evidence for cor pulmonale whereas the other was associated with lower LV function, findings reminiscent of the classic blue bloater and pink puffer COPD subtypes.

University of North Carolina at Chapel Hill (US), Midwestern University (US), Toyota Motor Corporation (Switzerland) (CH), University of Wisconsin System (US), University of Wisconsin–Madison (US), University of California, Los Angeles (US), University of California, San Francisco (US), Cornell University (US), University of Utah (US), Columbia University Irving Medical Center (US), University of Alabama at Birmingham (US), Northumbria University (GB), Medizinische Hochschule Hannover (DE), University of Illinois Chicago (US), University of Chicago (US), Ann Arbor Center for Independent Living (US), Wake Forest University (US), University of Baltimore (US), University of San Francisco (US)
Good health and well-being
Openalex Percentile: Top 63%
Chronic Obstructive Pulmonary Disease (COPD) Research
DOISourceOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.