Background Pulmonary microvasculature alterations are implicated in emphysema pathogenesis, but the association between pulmonary microvascular blood volume (PMBV) and emphysema has not been directly assessed at scale, and prior studies have used non-specific measures of emphysema. Methods The Multi-Ethnic Study of Atherosclerosis Lung Study invited participants recruited from the community without renal impairment to undergo contrast-enhanced dual-energy CT. Pulmonary blood volume was calculated by material decomposition; PMBV was defined as blood volume in the peripheral 2 cm of the lung. Non-contrast CT was acquired to assess per cent emphysema and novel CT emphysema subtypes, which include the diffuse emphysema subtype and small-airways-related combined bronchitic-apical emphysema subtype. Generalised linear regression models included age, sex, race/ethnicity, body size, smoking, total lung volume and small airway count. Results Among 495 participants, 53% were never-smokers and the race/ethnic distribution was 35% white, 31% black, 15% Hispanic and 18% Asian. Mean PMBV was 352±120 mL; mean per cent emphysema was 4.95±4.75%. Lower PMBV was associated with greater per cent emphysema (−0.90% per 100 mL PMBV, 95% CI: −1.29 to –0.51). The association was of larger magnitude in participants with 10 or more pack-years smoking and airflow obstruction, but present among participants with no smoking history or airflow limitation, and was specific to the diffuse CT emphysema subtype (−1.48% per 100 mL PMBV, 95% CI: −2.31 to –0.55). Conclusion In this community-based study, lower PMBV was associated with greater per cent emphysema, including in participants without a smoking history or airflow limitation, and was specific to the diffuse CT emphysema subtype. Data are available upon reasonable request. The data sets supporting the conclusions of this article can be accessed by reasonable request to MESA Publication and Presentations () in compliance with MESA and NHLBI/NIH data privacy and sharing standard practices and policy.

中文翻译：

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社区肺微血管血容量与肺气肿百分比和 CT 肺气肿亚型的相关性： MESA Lung 研究


背景 肺微血管系统改变与肺气肿发病机制有关，但肺微血管血容量 （PMBV） 与肺气肿之间的关联尚未得到大规模直接评估，既往研究使用了肺气肿的非特异性测量。方法 动脉粥样硬化多种族研究 肺研究 邀请从无肾功能损害的社区招募的参与者接受对比增强双能 CT。PMBV 定义为肺周边 2 cm 的血容量。获得非对比 CT 以评估百分比肺气肿和新型 CT 肺气肿亚型，其中包括弥漫性肺气肿亚型和小气道相关支气管-根尖联合肺气肿亚型。广义线性回归模型包括年龄、性别、种族/民族、体型、吸烟、肺总容量和小气道计数。结果 在 495 名参与者中，53% 是从不吸烟，种族/族裔分布为 35% 白人、31% 黑人、15% 西班牙裔和 18% 亚裔。平均 PMBV 为 352±120 mL;肺气肿的平均百分比为 4.95±4.75%。较低的 PMBV 与较高的肺气肿百分比相关 （-0.90% / 100 mL PMBV，95% CI： -1.29 至 -0.51）。这种关联在吸烟 10 包年或以上且气流阻塞的参与者中幅度更大，但在无吸烟史或气流受限的参与者中存在，并且特定于弥漫性 CT 肺气肿亚型（-1.48%/100 mL PMBV，95% CI：-2.31 至 -0.55）。结论 在这项基于社区的研究中，较低的 PMBV 与较高的肺气肿百分比相关，包括没有吸烟史或气流受限的参与者，并且特定于弥漫性 CT 肺气肿亚型。 数据可根据合理要求提供。支持本文结论的数据集可以通过向 MESA Publication and Presentations （） 提出合理请求来访问，以遵守 MESA 和 NHLBI/NIH 数据隐私并共享标准实践和政策。