Heart Checks With CT Scans

COPD patients can keep eye on future symptoms with CT scans

(RxWiki News) Being careful about smoking or hanging in smoky places certainly helps monitor your COPD. But how do you tell if things will keep going south?

A computed tomography (CT) scan combines X-rays from different angles and creates more detailed and realistic images of bones and tissues in the body.

This means CT scans are one of several ways to check your heart.

"See a heart doctor (cardiologist) with any questions."

Researchers, led by Mark Dransfield, MD, an associate professor in the UAB Division of Pulmonary, Allergy and Critical Care Medicine, used CT scans to look at the pulmonary artery and aorta of the heart.

The pulmonary artery takes blood from the heart to the lungs to get oxygen. Opposite of that, the aorta takes blood with oxygen from the heart to the rest of the body.

In the study, researchers looked at the CT scans of 5,469 patients from two studies. They paid attention to the size of the pulmonary artery compared to the aorta.

The patients were both current and former smokers with COPD.

In patients with COPD, researchers found that if the pulmonary artery grows in size in relation to the aorta, odds are that the disease will get worse.

Dransfield says there are a number of reasons that the pulmonary artery can get larger in patients with COPD, including having more pressure in the arteries and difficulty transferring oxygen to the bloodstream.

“The ability to predict which patients are likely to experience an exacerbation of their COPD symptoms requiring hospitalization is clinically significant,” said John Wells, M.D., an assistant professor in pulmonary medicine, in a press release.

“Physicians armed with this knowledge may be able to employ a more aggressive treatment to this population in an attempt to reduce their risk of hospitalization.”

CT scans are commonly done on patients with lung disease. Dransfield says they "are inexpensive and easy to read, potentially making the technique particularly useful for predicting exacerbations of COPD."

“This technique requires minimal training, is reproducible and can be obtained from routine CT images without the need for contrast or special software,” Dransfield said in a press release.

“Given the increased use of CT imaging in smokers, including the suggestion that COPD can be diagnosed with images alone, we suggest that the measurement of the ratio between the pulmonary artery and the aorta should be encouraged as a clinical tool.”

Using CT scans to predict whether COPD will get worse appears to be a better method than others, according to the authors.

But not all experts agree.

"The method illustrated in this article involves cost, radiation exposure, and the unproven belief that the pulmonary artery, aorta ratio is sufficiently dynamic to allow for meaningful use in a serial fashion for the evaluation of effectiveness of therapy,…" said Frank Meissner, MD, a clinical assistant professor at Texas Tech University Health Sciences Center.

Other methods include measuring lung function, quality of life, acid reflux and looking at previous episodes of exacerbation, according to Wells.

The study was published online Sept. 3 in the New England Journal of Medicine.

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Review Date: 
September 4, 2012