Evaluation Of Main Pulmonary Artery Elasticity In Patients With COPD Based On CT ECG Gating Technique

Objectives:To evaluate the changes of main pulmonary artery elasticity and to study the influencing factors of main pulmonary artery elasticity in patients with chronic obstructive pulmonary disease（COPD）by 320 row volume CT ECG-gated CT angiography.Methods:35 patients with chronic obstructive pulmonary disease（COPD）,who has finished cardiovascular CTA examination,were collected from the Second people’s Hospital of Yunnan Province from November 2021 to January 2023,including 29males and 6 females,aged from 51 to 91 years,with an average of（74.74±9.46）years.In the same period,a total of 35 non-COPD patients with similar age and sex were collected as the control group,including 26 males and 9 females,ranging in age from 50 to 88 years,with an average of 73.00（68.00,81.00）years.The basic clinical data such as height,weight,smoking history,drinking history,hypertension and diabetes were collected by querying the subjects’clinical electronic medical records or asking directly.Referring to the results of pulmonary function examination of the subjects in the COPD group,the severity of the disease was classified as GOLD according to the 2022 version of the chronic obstructive Pulmonary Disease Global Initiative（GOLD）,which was divided into I～IV grade.The subjects used electronic sphygmomanometer to measure brachial artery blood pressure and finger clip pulse oximeter to measure their heart rate before cardiovascular CTA examination.The research subjects were examined by CT-gated cardiovascular CTA using Toshiba Aquilion ONE 320 volumetric CT imager,and the original data were reconstructed in full phase every interval 10%RR interval,and 5%,15%...95%10 phase data were obtained.Then the diameter and lumen area of main pulmonary artery in different phases of the same plane were measured on the post-processing workstation with Aquilion ONE 320 CT and Vitrea FX.Arterial elasticity was evaluated by arterial distensibility（AD）,compliance（AC）and stiffness（ASI/β）.Independent sample T test,rank sum test,Pearson correlation analysis,Spearman correlation analysis and multivariate linear regression were used for statistical analysis.The difference was statistically significant（P<0.05）.Results:1.There was no significant difference in the composition of general data between the COPD group and the control group（P>0.05）;2.There were significant differences in main pulmonary artery elasticity parameters（AD,AC andβ）between the COPD group and control group.The difference of main pulmonary artery elasticity parameters was significant in AD（P<0.001）;3.Age was the independent influencing factor of arterial elasticity parameters AD andβin patients with COPD（P<0.001）.The arterial elasticity parameter AD was negatively correlated with age(B=2.788×10^-5,P=0.000)and decreased with age,whileβwas positively correlated with age（B=0.018,P=0.000）and increased with age;4.Smoking was the independent influencing factor of main pulmonary artery elasticity parameters AD andβin patients with COPD（P<0.05）.The AD of smokers was lower than that of non-smokers（B=-0.000,P=0.013）,and theβof smokers was higher than that of non-smokers（B=0.261,P=0.045）.Conclusions:1.The main pulmonary artery elasticity of patients with COPD was lower than that of the control group,and the difference of main pulmonary artery elasticity between the COPD group and the control group was significant with AD;2.Age and smoking events are independent risk factors for main pulmonary artery elasticity of patients with COPD.