CT Scan Identifies Risk for COPD Exacerbation

CT imaging can identify pulmonary artery enlargement, which is associated with exacerbation of chronic obstructive pulmonary disease (COPD), according to a study published in the most recent issue of New England Journal of Medicine.

Researchers assessed the use of CT imaging to determine the ratio of the diameter of the pulmonary artery to the diameter of the aorta, with the hypothesis that a PA:A ratio of more than 1 would be associated with severe COPD exacerbations.

The 3,464 participating patients were 45 to 80 years old and current or former smokers, with a history of 10 pack-years or more of cigarette smoking. Volumetric CT scans of the chest were obtained without contrast material.

Findings showed “a significant association between a PA:A ratio >1 and a history of severe COPD exacerbations at the time of enrollment in the trial,” wrote the authors. Fifty-three percent of patients with a PA:A ratio of more than 1 reported a severe COPD exacerbation in the year before enrollment into the study, compared with 13 percent with a PA:A ratio of 1 or less who experienced exacerbations. Many of the exacerbations required hospitalization.

This ratio was also independently associated with an increased risk of future severe exacerbations in both the trial cohort and the external validation cohort, the authors noted.