Applied Chest Imaging Laboratory

Pulmonary Vascular Remodeling in Smokers

Grant support: NIH/NHLBI 1R01HL116473-01
Multiple PI: Dr. George R. Washko, Dr. Raul San Jose Estepar

Project Information:

The purpose of this investigation is to improve understanding of the clinical impact and epidemiologic associations of pulmonary vascular remodeling in smokers. We will do this by performing CT based quantitative measures of the mediastinal and intra-parenchymal vasculature in all subjects enrolled in the COPDGene Study and then clinically validating these measures with echocardiography, cardiac MRI and measures of DLCO (Aim 3). In the final steps of Aim 3 we will examine the overlap and associations between pulmonary and cardiovascular disease (both clinical diagnosed CVD and both coronary and thoracic aortic calcification) and the relationship between pulmonary vascular morphology and exercise capacity, acute exacerbations of COPD, symptoms, and mortality. We believe that this will lead to improved understanding of the pathophysiology of COPD and may ultimately improve the care of patients with COPD.

People Involved:

Dr. Alejandro A. Diaz, Dr. John Hokanson, Dr. James Ross, Dr. Raúl San José Estépar, Dr. George R Washko


Ross JC, Kindlmann GL, Okajima Y, Hatabu H, Díaz AA, Silverman EK, Washko GR, Dy J, San José Estépar R. Pulmonary lobe segmentation based on ridge surface sampling and shape model fitting. Med Phys 2013;40(12):121903. Abstract


Wells MJ, Iyer AS, Rahaghi FN, Bhatt SP, Gupta H, Denney TS, Lloyd SG, Dell’Italia LJ, Nath H, Estepar RSJ, Washko GR, Dransfield MT. Pulmonary artery enlargement is associated with right ventricular dysfunction and loss of blood volume in small pulmonary vessels in chronic obstructive pulmonary disease. Circ Cardiovasc Imaging 2015;8(4) Abstract

San José Estépar R, Kinney GL, Black-Shinn JL, Bowler RP, Kindlmann GL, Ross JC, Kikinis R, Han MLK, Come CE, Diaz AA, Cho MH, Hersh CP, Schroeder JD, Reilly JJ, Lynch DA, Crapo JD, Wells MJ, Dransfield MT, Hokanson JE, Washko GR. Computed tomographic measures of pulmonary vascular morphology in smokers and their clinical implications. Am J Respir Crit Care Med 2013;188(2):231-9. Abstract