Comparison of CT scan-measured pulmonary artery to aorta ratio of combined pulmonary fibrosis and emphysema (CPFE) and COPD

Abstract

Rationale: Cottin first described CPFE and there is accumulating evidence that respiratory dysfunction is more severe and the prevalence of pulmonary arterial hypertension (PAH) is higher in patients with CPFE than in patients with COPD alone. It has recently been reported that relative pulmonary artery (PA) enlargement, defined as a PA to ascending aorta (A) diameter ratio greater than one (PA:A>1) is associated with severe exacerbations in COPD patients, but there is little information about clinical features of CPFE. Therefore, in the present study, we compared clinical characteristics between patients of CPFE and COPD, including the evaluation of PA/A ratio and the cardiovascular disease. Methods: We conducted a retrospective observational study of patients with COPD (n=41) and CPFE (n=24) in our outpatient clinic. We compared the two groups in terms of age, sex, smoking history, severity, comorbidity, and pulmonary function. We also evaluated a ratio of PA/A in predicting PAH, according to the measurement by CT. Results: There were no differences between the two groups in terms of age, sex, and smoking history. FEV 1 /FVC ratio in the CPFE group was significantly higher than that in the COPD group (72.6% vs. 53.1%, p Conclusions: These results suggest that, in patients with CPFE, coronary artery diseases which require PCI are often comorbid, but influences of this comorbidity in the development of CPFE remain to be elucidated.