Lucie Cassagnes MD, Presenter: Nothing to Disclose

Emanuela Algeri MD, Abstract Co-Author: Nothing to Disclose

Teresa Santangelo MD, Abstract Co-Author: Nothing to Disclose

Jean-Baptiste Faivre, Abstract Co-Author: Nothing to Disclose

Jacques Remy MD, Abstract Co-Author: Research Consultant, Siemens AG

Martine J. Remy-Jardin MD, PhD, Abstract Co-Author: Research grant, Siemens AG

To evaluate left atrial (LA) volume in COPD patients according to the severity of emphysema and total lung volume (TLV).

112 consecutive COPD patients (82 males; 30 females; mean age: 57 yr; mean tobacco consumption: 41 pack-years), free of clinical cardiovascular disease, underwent a prospectively ECG-gated CT angiographic examination of the chest with dual-source, single-energy CT (120 kV –200 mAs/rotation; collimation: 64 x 2 x 0.6 mm; pitch: 3.2 ; rotation time : 0.28 s ; 60% of the R-R interval). An automated quantification of lung volumes and emphysema was obtained using a dedicated software (MevisPulmo; Bremen, Germany). LA volume measurements, normalized to body surface area, were calculated using the Inspace software, after exclusion of the pulmonary veins.

The CT phenotypes of the studied population were as follows: emphysema-predominant (n=54); airway-predominant (n=25); a mixed pattern of emphysema and airways disease (n=14), and absence of CT abnormalities (n=19). Considering a threshold of 15% of emphysematous lung destruction to separate the entire study group in patients with mild-to-moderate emphysema (Group 1; n=94) (mean and median values of emphysema: 3.48%, 2.1%; range: 0- 14) and patients with severe emphysema (Group 2; n= 18) (mean and median values of emphysema 23.4% , 23.7%; range : 15-44.1), we observed that the LA volume was significantly lower in Group 2 (mean and median values : 36.9 mL/m2, 36.1 mL/m2; range: 22.4- 50.7) compared to Group 1 (mean and median values: 45.82 mL/m2, 43.86mL/m2; range: 22.5- 107.8) (p=0.0213). In Group 2, a trend towards a negative correlation was found between the LA volume and TLV (r=- 0.4571; p=0.0565). In the emphysema-predominant CT phenotype, the LA volume was inversely correlated with the percentage of emphysema in the right lung (r= -0.2943; p=0.03).

The LA volume is significantly reduced in patients with severe emphysema.

In COPD patients, reduced pulmonary venous return secondary to severe lung destruction can be suspected on the basis of LA volume reduction, itself suggesting alteration in left ventricular filling.

Cassagnes, L, Algeri, E, Santangelo, T, Faivre, J, Remy, J, Remy-Jardin, M, Left Atrial Volume in Chronic Obstructive Pulmonary Disease (COPD): Can CT Help Recognize a Link between the Extent of Emphysema and Reduced Pulmonary Venous Return?.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034455.html