{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:43:31Z","timestamp":1792698211378,"version":"4.5.0"},"reference-count":33,"publisher":"European Respiratory Society (ERS)","issue":"2","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["205188\/Z\/16\/Z"],"award-info":[{"award-number":["205188\/Z\/16\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["206632\/Z\/17\/Z"],"award-info":[{"award-number":["206632\/Z\/17\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2022,2,10]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Pulmonary hypertension (PH) in patients with chronic lung disease (CLD) predicts reduced functional status, clinical worsening and increased mortality, with patients with severe PH-CLD (\u226535\u2005mmHg) having a significantly worse prognosis than mild to moderate PH-CLD (21\u201334\u2005mmHg). The aim of this cross-sectional study was to assess the association between computed tomography (CT)-derived quantitative pulmonary vessel volume, PH severity and disease aetiology in CLD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Treatment-na\u00efve patients with CLD who underwent CT pulmonary angiography, lung function testing and right heart catheterisation were identified from the ASPIRE registry between October 2012 and July 2018. Quantitative assessments of total pulmonary vessel and small pulmonary vessel volume were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>90 patients had PH-CLD including 44 associated with COPD\/emphysema and 46 with interstitial lung disease (ILD). Patients with severe PH-CLD (n=40) had lower small pulmonary vessel volume compared to patients with mild to moderate PH-CLD (n=50). Patients with PH-ILD had significantly reduced small pulmonary blood vessel volume, compared to PH-COPD\/emphysema. Higher mortality was identified in patients with lower small pulmonary vessel volume.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with severe PH-CLD, regardless of aetiology, have lower small pulmonary vessel volume compared to patients with mild\u2013moderate PH-CLD, and this is associated with a higher mortality. Whether pulmonary vessel changes quantified by CT are a marker of remodelling of the distal pulmonary vasculature requires further study.<\/jats:p><\/jats:sec>","DOI":"10.1183\/23120541.00503-2021","type":"journal-article","created":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T15:55:12Z","timestamp":1649346912000},"page":"00503-2021","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":33,"title":["Severe pulmonary hypertension associated with lung disease is characterised by a loss of small pulmonary vessels on quantitative computed tomography"],"prefix":"10.1183","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4726-7365","authenticated-orcid":false,"given":"Dheyaa","family":"Alkhanfar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7425-7798","authenticated-orcid":false,"given":"Yousef","family":"Shahin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1227-401X","authenticated-orcid":false,"given":"Faisal","family":"Alandejani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krit","family":"Dwivedi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9960-7587","authenticated-orcid":false,"given":"Samer","family":"Alabed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Johns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4192-9505","authenticated-orcid":false,"given":"Allan","family":"Lawrie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0717-4551","authenticated-orcid":false,"given":"A.A. Roger","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander M.K.","family":"Rothman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juerg","family":"Tschirren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna M.","family":"Uthoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Hoffman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3492-4143","authenticated-orcid":false,"given":"Robin","family":"Condliffe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim M.","family":"Wild","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0184-6502","authenticated-orcid":false,"given":"David G.","family":"Kiely","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Swift","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2022,4,7]]},"reference":[{"key":"2024101711310035000_8.2.00503-2021.1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200401-006OC"},{"key":"2024101711310035000_8.2.00503-2021.2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00015608"},{"key":"2024101711310035000_8.2.00503-2021.3","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00079512"},{"key":"2024101711310035000_8.2.00503-2021.4","doi-asserted-by":"crossref","unstructured":"Kiely DG , Levin D , Hassoun P , et al. EXPRESS: Statement on imaging and pulmonary hypertension from the Pulmonary Vascular Research Institute (PVRI). Pulm Circ 2019; 9: 2045894019841990.","DOI":"10.1177\/2045894019841990"},{"key":"2024101711310035000_8.2.00503-2021.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2005.08.013"},{"key":"2024101711310035000_8.2.00503-2021.6","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1053\/j.sult.2013.10.005","article-title":"High-resolution computed tomography features of smoking-related interstitial lung disease","volume":"35","author":"Nair","year":"2014","journal-title":"Semin Ultrasound CT MR"},{"key":"2024101711310035000_8.2.00503-2021.7","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.acra.2013.12.015","article-title":"CT-based pulmonary artery measurements for the assessment of pulmonary hypertension","volume":"21","author":"Corson","year":"2014","journal-title":"Acad Radiol"},{"key":"2024101711310035000_8.2.00503-2021.8","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3389\/fcvm.2018.00053","article-title":"Pulmonary artery size in interstitial lung disease and pulmonary hypertension: association with interstitial lung disease severity and diagnostic utility","volume":"5","author":"Chin","year":"2018","journal-title":"Front Cardiovasc Med"},{"key":"2024101711310035000_8.2.00503-2021.9","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1007\/s10554-015-0618-x","article-title":"Predicting pulmonary hypertension with standard computed tomography pulmonary angiography","volume":"31","author":"Spruijt","year":"2015","journal-title":"Int J Cardiovasc Imaging"},{"key":"2024101711310035000_8.2.00503-2021.10","doi-asserted-by":"crossref","first-page":"4918","DOI":"10.1007\/s00330-020-06846-1","article-title":"Diagnostic accuracy of CT pulmonary angiography in suspected pulmonary hypertension","volume":"30","author":"Swift","year":"2020","journal-title":"Eur Radiol"},{"key":"2024101711310035000_8.2.00503-2021.11","doi-asserted-by":"crossref","first-page":"e87515","DOI":"10.1371\/journal.pone.0087515","article-title":"Quantification of tortuosity and fractal dimension of the lung vessels in pulmonary hypertension patients","volume":"9","author":"Helmberger","year":"2014","journal-title":"PLoS One"},{"key":"2024101711310035000_8.2.00503-2021.12","doi-asserted-by":"crossref","first-page":"9712970","DOI":"10.1155\/2019\/9712970","article-title":"An approach for pulmonary vascular extraction from chest CT images","volume":"2019","author":"Tan","year":"2019","journal-title":"J Healthc Eng"},{"key":"2024101711310035000_8.2.00503-2021.13","doi-asserted-by":"crossref","first-page":"636240","DOI":"10.1155\/2009\/636240","article-title":"Segmentation of pulmonary vascular trees from thoracic 3D CT images","volume":"2009","author":"Shikata","year":"2009","journal-title":"Int J Biomed Imaging"},{"key":"2024101711310035000_8.2.00503-2021.14","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2015-207696"},{"key":"2024101711310035000_8.2.00503-2021.15","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00078411"},{"key":"2024101711310035000_8.2.00503-2021.16","unstructured":"National Institute for Health and Clinical Excellence . Chronic Obstructive Pulmonary Disease. Management of chronic obstructive pulmonary disease in adults in primary and secondary care (partial update). https:\/\/www.nice.org.uk\/guidance\/CG101 Date last accessed: 26 April 2012. Date last updated: June 2010."},{"key":"2024101711310035000_8.2.00503-2021.17","doi-asserted-by":"crossref","first-page":"F1000","DOI":"10.12688\/f1000research.18811.1","article-title":"The 6th World Symposium on Pulmonary Hypertension: what's old is new","volume":"8","author":"Condon","year":"2019","journal-title":"F1000Res"},{"key":"2024101711310035000_8.2.00503-2021.18","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201407-1205OC"},{"key":"2024101711310035000_8.2.00503-2021.19","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1159\/000439544","article-title":"Patterns of emphysema heterogeneity","volume":"90","author":"Valipour","year":"2015","journal-title":"Respiration"},{"key":"2024101711310035000_8.2.00503-2021.20","doi-asserted-by":"crossref","unstructured":"Aaron CP , Hoffman EA , Kawut SM , et al. Ambient air pollution and pulmonary vascular volume on computed tomography: the MESA Air Pollution and Lung cohort studies. Eur Respir J 2019; 53: 1802116. doi:10.1183\/13993003.02116-2018","DOI":"10.1183\/13993003.02116-2018"},{"key":"2024101711310035000_8.2.00503-2021.21","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201506-1196OC"},{"key":"2024101711310035000_8.2.00503-2021.22","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/j.acra.2020.03.006","article-title":"CT pulmonary vessels and MRI ventilation in chronic obstructive pulmonary disease: relationship with worsening FEV1 in the TINCan cohort study","volume":"28","author":"Barker","year":"2021","journal-title":"Acad Radiol"},{"key":"2024101711310035000_8.2.00503-2021.23","first-page":"72","volume":"14","author":"Karazincir","year":"2008","journal-title":"Diagn Interv Radiol"},{"key":"2024101711310035000_8.2.00503-2021.24","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1164\/rccm.201801-0095PP","article-title":"Pulmonary vascular involvement in chronic obstructive pulmonary disease. Is there a pulmonary vascular phenotype?","volume":"198","author":"Kovacs","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"key":"2024101711310035000_8.2.00503-2021.25","doi-asserted-by":"crossref","first-page":"S45","DOI":"10.1016\/S0167-5273(11)70492-2","article-title":"Pulmonary hypertension due to chronic lung disease: updated Recommendations of the Cologne Consensus Conference 2011","volume":"154: Suppl 1","author":"Hoeper","year":"2011","journal-title":"Int J Cardiol"},{"key":"2024101711310035000_8.2.00503-2021.26","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0087"},{"key":"2024101711310035000_8.2.00503-2021.27","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02008-2021"},{"key":"2024101711310035000_8.2.00503-2021.28","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00944-2021"},{"key":"2024101711310035000_8.2.00503-2021.29","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2009.07.022"},{"key":"2024101711310035000_8.2.00503-2021.30","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1111\/resp.13485","article-title":"Quantitative CT-derived vessel metrics in idiopathic pulmonary fibrosis: a structure-function study","volume":"24","author":"Jacob","year":"2019","journal-title":"Respirology"},{"key":"2024101711310035000_8.2.00503-2021.31","doi-asserted-by":"crossref","unstructured":"Jacob J , Bartholmai BJ , Rajagopalan S , et al. Mortality prediction in idiopathic pulmonary fibrosis: evaluation of computer-based CT analysis with conventional severity measures. Eur Respir J 2017; 49: 1601011. doi:10.1183\/13993003.01011-2016.","DOI":"10.1183\/13993003.01011-2016"},{"key":"2024101711310035000_8.2.00503-2021.32","doi-asserted-by":"crossref","first-page":"679","DOI":"10.3390\/diagnostics11040679","article-title":"Pulmonary hypertension in association with lung disease: quantitative CT and artificial intelligence to the rescue? State-of-the-art review","volume":"11","author":"Dwivedi","year":"2021","journal-title":"Diagnostics (Basel)"},{"key":"2024101711310035000_8.2.00503-2021.33","doi-asserted-by":"crossref","first-page":"2428","DOI":"10.1109\/TMI.2018.2833385","article-title":"Pulmonary artery\u2013vein classification in CT images using deep learning","volume":"37","author":"Nardelli","year":"2018","journal-title":"IEEE Trans Med Imaging"}],"container-title":["ERJ Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/23120541.00503-2021","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T05:15:01Z","timestamp":1740374101000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/23120541.00503-2021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":33,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,5,16]]},"published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1183\/23120541.00503-2021"],"URL":"https:\/\/doi.org\/10.1183\/23120541.00503-2021","relation":{},"ISSN":["2312-0541"],"issn-type":[{"value":"2312-0541","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4]]}}}