High Resolution Computed Tomography Assessment of Pulmonary Artery Diameters in Chronic Obstructive Pulmonary Disease: A Cross-Sectional Comparative Study

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder frequently associated with pulmonary vascular remodeling and pulmonary hypertension, both of which contribute to increased morbidity and mortality. To evaluate pulmonary artery diameters using computed tomography in patients with chronic obstructive pulmonary disease, compare the findings with non-COPD participants, and assess the influence of smoking on pulmonary artery dimensions. Materials and Methods: A hospital-based cross-sectional study was conducted among 200 participants (100 females and 100 males) aged 18–70 years. Chest CT examinations were performed using a standardized multidetector CT protocol. The diameters of the main pulmonary artery (MPA), left pulmonary artery (LPA), and right pulmonary artery (RPA) were measured on axial CT images. Participants were categorized into COPD and non-COPD groups and further classified according to smoking status. Descriptive statistics were calculated, and independent Student's t-tests were used to compare pulmonary artery diameters between groups. A p-value <0.05 was considered statistically significant. Results: The mean age of the study population was 42.20 ± 15.91 years. The mean diameters of the MPA, LPA, and RPA were 26.36 ± 2.45 mm, 16.11 ± 1.68 mm, and 17.15 ± 1.61 mm, respectively. COPD patients demonstrated significantly larger pulmonary artery diameters than non-COPD participants, including the MPA (27.46 ± 2.51 mm vs. 25.47 ± 2.02 mm; p < 0.01), LPA (16.72 ± 1.46 mm vs. 15.61 ± 1.69 mm; p < 0.01), and RPA (17.85 ± 1.55 mm vs. 16.58 ± 1.43 mm; p < 0.02). Smokers also exhibited significantly greater pulmonary artery diameters than non-smokers, with the MPA measuring 27.48 ± 2.35 mm versus 25.26 ± 2.03 mm (p < 0.001). Histogram analysis demonstrated that most COPD patients had MPA diameters between 25 and 29 mm, while a subset exceeded the 29 mm threshold for pulmonary artery dilatation. Conclusion: Pulmonary artery diameters measured by computed tomography are significantly increased in patients with COPD and in smokers, indicating pulmonary vascular remodeling associated with chronic lung disease and tobacco exposure. CT-based assessment of pulmonary artery dimensions, particularly the main pulmonary artery, represents a simple, reproducible, and non-invasive imaging biomarker that may facilitate the early identification of pulmonary vascular involvement and aid in the screening of patients at risk for pulmonary hypertension.