Rahaghi Farbod N, van Beek Edwin J R, Washko George R
*The Brigham and Women's Hospital, Pulmonary and Critical Care Medicine, Boston, MA †Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK.
J Thorac Imaging. 2014 Mar;29(2):80-91. doi: 10.1097/RTI.0000000000000076.
Chronic obstructive pulmonary disorder (COPD) is a systemic disease that affects the cardiovascular system through multiple pathways. Pulmonary hypertension, ventricular dysfunction, and atherosclerosis are associated with smoking and COPD, causing significant morbidity and poor prognosis. Coupling between the pulmonary and cardiovascular system involves mechanical interdependence and inflammatory pathways that potentially affect the entire circulation. Although treatments specific for COPD-related cardiovascular and pulmonary vascular disease are limited, early diagnosis, study of pathophysiology, and monitoring the effects of treatment are enhanced with improved imaging techniques. In this article, we review recent advancements in the imaging of the vasculature and the heart in patients with COPD. We also explore the potential mechanism of coupling between the progression of COPD and vascular disease. Imaging methods reviewed include specific implementations of computed tomography, magnetic resonance imaging, dual-energy computed tomography, positron emission tomography, and echocardiography. Specific applications to the proximal and distal pulmonary vasculature, as well as to the heart and systemic circulation, are also discussed.
慢性阻塞性肺疾病（COPD）是一种全身性疾病，通过多种途径影响心血管系统。肺动脉高压、心室功能障碍和动脉粥样硬化与吸烟及COPD相关，会导致严重的发病率和不良预后。肺循环和心血管系统之间的耦合涉及机械相互依存和炎症途径，可能会影响整个循环系统。尽管针对COPD相关心血管和肺血管疾病的治疗方法有限，但借助改进的成像技术可实现早期诊断、病理生理学研究以及治疗效果监测。在本文中，我们回顾了COPD患者血管和心脏成像方面的最新进展。我们还探讨了COPD进展与血管疾病之间耦合的潜在机制。所回顾的成像方法包括计算机断层扫描、磁共振成像、双能计算机断层扫描、正电子发射断层扫描和超声心动图的具体应用。还讨论了这些成像方法在近端和远端肺血管以及心脏和体循环中的具体应用。
