The determinants of exercise intolerance in heart failure (HF) are multifactorial.
Moreover, the role of thoracic vascular imaging still remains scarce in its evaluation.
For example, a reduction in lung cross-sectional area of vessels < 5 mm in diameter
(%CSA<5) in smokers was associated with a reduction in six-minute walking distance.
1
In addition, the relationship between the pulmonary artery and aortic diameters (PA/Ao
ratio) becomes a promising marker related to exercise capacity in chronic obstructive
pulmonary disease.
2
Of note, one study has shown a close relationship between PA/Ao ratio and %CSA<5
with hemodynamic variables regarded as crucial determinants of exercise capacity in
pulmonary arterial hypertension (PAH).
- Chung KS
- Kim YS
- Kim SK
- et al.
Functional and prognostic implications of the main pulmonary artery diameter to aorta
diameter ratio from chest computed tomography in Korean COPD patients.
PLoS One. 2016; 11e0154584https://doi.org/10.1371/journal.pone.0154584
3
On the other hand, pulmonary vascular alterations with endothelial dysfunction would
trigger other abnormalities, such as non-smoking-related emphysema by activation of
apoptosis.
4
Accordingly, emphysema-like physiological abnormalities during exercise in HF, such
as dynamic hyperinflation and ventilatory constraints,
5
have not yet been addressed with detailed pulmonary imaging techniques in subjects
without criteria for obstructive lung disease. Thus, this study aims to explore whether
thoracic vascular imaging and emphysema metrics are related to metabolic, ventilatory
and circulatory adjustments during incremental exercise, seeking to expand the monitoring
capabilities of HF-associated vasculopathy and its consequences on physical activity.To read this article in full you will need to make a payment
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References
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- Functional and prognostic implications of the main pulmonary artery diameter to aorta diameter ratio from chest computed tomography in Korean COPD patients.PLoS One. 2016; 11e0154584https://doi.org/10.1371/journal.pone.0154584
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Article info
Publication history
Published online: May 16, 2022
Accepted:
May 11,
2022
Received:
February 15,
2021
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
