Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
COPD. 2010 Dec;7(6):404-10. doi: 10.3109/15412555.2010.528085.
COPD patients are at increased risk for cardiovascular morbidity and mortality independent of smoking habits. Recent studies suggest CT emphysema is an independent predictor of cardiovascular risk as evidenced by its association with arterial stiffness and impaired endothelial function. We examined the relationship between demographics, lung function, CT emphysema and airway wall thickness and thoracic aortic calcification, another marker of cardiovascular risk, in the National Lung Screening Trial. We hypothesized that CT emphysema would be independently associated with thoracic aortic calcification. Two hundred forty current and former smokers were enrolled. After CT examination, we recorded subjects' demographics and they performed spirometry. Subjects were classified into COPD and non-COPD subgroups. CT emphysema was quantified as a percentage of lung volume and measurements of the right upper lobe airway were performed using standard methods and expressed as wall area (%). Total calcification scores for the thoracic aorta were computed using TeraRecon image analysis. Univariate and multivariate analyses were performed to determine the associations between calcium score and subject characteristics. Subjects with COPD were older, more often male, heavier smokers and had more CT emphysema and greater aortic calcification than those without COPD. Calcium score was associated with age, pack-years, CT emphysema, wall area%, and lung function on univariate testing but only with age and CT emphysema on multivariate analysis. We conclude that CT emphysema is independently associated with thoracic calcification and thus may be used to assess cardiovascular risk in smokers with and without COPD.
COPD 患者的心血管发病率和死亡率高于不吸烟者。最近的研究表明，CT 肺气肿是心血管风险的独立预测因子，其与动脉僵硬和内皮功能受损有关。我们在全国肺癌筛查试验中检查了人口统计学、肺功能、CT 肺气肿和气道壁厚度与胸主动脉钙化（另一个心血管风险标志物）之间的关系。我们假设 CT 肺气肿与胸主动脉钙化独立相关。我们招募了 240 名目前和以前的吸烟者。在 CT 检查后，我们记录了受试者的人口统计学资料，并进行了肺活量测定。受试者分为 COPD 和非 COPD 亚组。使用标准方法对 CT 肺气肿进行了作为肺容积百分比的定量测量，并对右上肺气道进行了测量，结果表示为壁面积（%）。使用 TeraRecon 图像分析计算了胸主动脉的总钙化评分。进行单变量和多变量分析以确定钙评分与受试者特征之间的关联。与无 COPD 的受试者相比，COPD 患者年龄更大、更常为男性、吸烟量更大、CT 肺气肿更严重、主动脉钙化更多。在单变量测试中，钙评分与年龄、吸烟包年数、CT 肺气肿、壁面积%和肺功能有关，但在多变量分析中仅与年龄和 CT 肺气肿有关。我们得出结论，CT 肺气肿与胸主动脉钙化独立相关，因此可用于评估 COPD 患者和非 COPD 吸烟者的心血管风险。
