Evidence map›Paper›PMID 26501747›Full record

ArticleChest2016

Pulmonary Artery Enlargement Is Associated With Cardiac Injury During Severe Exacerbations of COPD.

J Michael Wells, Joshua B Morrison, Surya P Bhatt, Hrudaya Nath, Mark T Dransfield

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Chest, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 2 pooled it
3.3field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.

  1. Pooled it
  2. Thoracic Imaging at Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review.International journal of chronic obstructive pulmonary disease · 2020
    Pooled it
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  18. Assessing pulmonary hypertension in COPD. Is there a role for computed tomography?International journal of chronic obstructive pulmonary disease · 2019
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

J Michael WellsDivision of Pulmonary, Allergy, and Critical Care, University of Alabama at Birmingham, Birmingham, AL; Department of Medicine, University of Alabama at Birmingham, Birmingham, AL; Lung Health Center, University of Alabama at Birmingham, Birmingham, AL; Birmingham VA Medical Center, Birmingham, AL. Electronic address: jmwells@uab.edu.
Joshua B MorrisonDivision of Pulmonary, Allergy, and Critical Care, University of Alabama at Birmingham, Birmingham, AL; Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.
Surya P BhattDivision of Pulmonary, Allergy, and Critical Care, University of Alabama at Birmingham, Birmingham, AL; Department of Medicine, University of Alabama at Birmingham, Birmingham, AL; Lung Health Center, University of Alabama at Birmingham, Birmingham, AL.
Hrudaya NathDivision of Cardiothoracic Imaging, Department of Radiology, University of Alabama at Birmingham, Birmingham, AL.
Mark T DransfieldDivision of Pulmonary, Allergy, and Critical Care, University of Alabama at Birmingham, Birmingham, AL; Department of Medicine, University of Alabama at Birmingham, Birmingham, AL; Lung Health Center, University of Alabama at Birmingham, Birmingham, AL; Birmingham VA Medical Center, Birmingham, AL.
University of Alabama at Birmingham · USBirmingham VA Medical Center · US

Funding

The Role of PGP in COPD-associated Pulmonary HypertensionK08HL123940 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI WELLS, JAMES MICHAEL · 2014 to 2018
$744k
NHLBI NIH HHS K08 HL123940
6 · The paper itself

Abstract

backgroundRelative pulmonary arterial enlargement, defined by a pulmonary artery to aorta (PA/A) ratio > 1 on CT scanning, predicts hospitalization for acute exacerbations of COPD (AECOPD). However, it is unclear how AECOPD affect the PA/A ratio. We hypothesized that the PA/A ratio would increase at the time of AECOPD and that a ratio > 1 would be associated with worse clinical outcomes.

methodsPatients discharged with an International Classification of Diseases, Ninth Revision, diagnosis of AECOPD from a single center over a 5-year period were identified. Patients were included who had a CT scan performed during the stable period prior to the index AECOPD episode as well as a CT scan at the time of hospitalization. A subset of patients also underwent postexacerbation CT scans. The pulmonary arterial diameter, ascending aortic diameter, and the PA/A ratio were measured on CT scans. Demographic data, comorbidities, troponin level, and hospital outcome data were analyzed.

resultsA total of 134 patients were included in the study. They had a mean age of 65 ± 10 years, 47% were male, and 69% were white; overall, patients had a mean FEV1 of 47% ± 19%. The PA/A ratio increased from baseline at the time of exacerbation (0.97 ± 0.15 from 0.91 ± 0.17; P < .001). Younger age and known pulmonary hypertension were independently associated with an exacerbation PA/A ratio > 1. Patients with PA/A ratio > 1 had higher troponin values. Those with a PA/A ratio > 1 and troponin levels > 0.01 ng/mL had increased acute respiratory failure, ICU admission, or inpatient mortality compared with those without both factors (P = .0028). The PA/A ratio returned to baseline values following AECOPD.

conclusionsThe PA/A ratio increased at the time of severe AECOPD and a ratio > 1 predicted cardiac injury and a more severe hospital course.

Indexed as

AgedAge FactorsDisease ProgressionFemaleForced Expiratory VolumeHeart DiseasesHumansHypertension, PulmonaryLogistic ModelsMaleMiddle AgedMultivariate AnalysisOrgan SizeOxygen Inhalation TherapyPulmonary ArteryPulmonary Disease, Chronic ObstructiveTroponinacute exacerbation of COPDCOPDCT scanenzymes (cardiology)pulmonary circulation

Identifiers

PMID26501747
PMCPMC4944777
OpenAlexW2240103478

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.