Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comment
. 2019 Aug 15;200(4):406-408.
doi: 10.1164/rccm.201901-0248ED.

Seeing the Forest for the (Arterial) Tree: Vascular Pruning and the Chronic Obstructive Pulmonary Disease Pulmonary Vascular Phenotype

Jason Weatherald  1   2 , David Montani  3   4   5 , Marc Humbert  3   4   5
Affiliations
Comment

Seeing the Forest for the (Arterial) Tree: Vascular Pruning and the Chronic Obstructive Pulmonary Disease Pulmonary Vascular Phenotype

Jason Weatherald et al. Am J Respir Crit Care Med. .
No abstract available

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
(A) A normal, healthy bronchovascular tree. Imagine the airways and alveoli are like branches on a tree with pulmonary arterial–capillary networks reflecting the individual leaves. (B) In most patients with chronic obstructive pulmonary disease, smoking-induced damage to the distal airways and alveolar destruction are the main mechanisms for loss of the pulmonary vascular bed and the consequent pulmonary hypertension. Dropout of the distal arteries and capillaries (leaves) is congruent with the degree of damage to the branches (i.e., emphysema and severe airflow obstruction). (C) In patients with chronic obstructive pulmonary disease with a pulmonary vascular phenotype, smoking-related vascular injury predominates. There may be primarily a loss of the distal arterial–capillary networks (pruning of the leaves) with relative preservation of the airways and alveoli (branches). Illustration by Patricia Ferrer Beals.
See this image and copyright information in PMC

Comment on

References

    1. Andersen KH, Iversen M, Kjaergaard J, Mortensen J, Nielsen-Kudsk JE, Bendstrup E, et al. Prevalence, predictors, and survival in pulmonary hypertension related to end-stage chronic obstructive pulmonary disease. J Heart Lung Transplant. 2012;31:373–380. - PubMed
    1. Chaouat A, Bugnet A-S, Kadaoui N, Schott R, Enache I, Ducoloné A, et al. Severe pulmonary hypertension and chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2005;172:189–194. - PubMed
    1. Galiè N, Humbert M, Vachiery J-L, Gibbs S, Lang I, Torbicki A, et al. 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension: the Joint Task Force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT) Eur Respir J. 2015;46:903–975. - PubMed
    1. Kovacs G, Agusti A, Barberà JA, Celli B, Criner G, Humbert M, et al. Pulmonary vascular involvement in chronic obstructive pulmonary disease: is there a pulmonary vascular phenotype? Am J Respir Crit Care Med. 2018;198:1000–1011. - PubMed
    1. Nathan SD, Barbera JA, Gaine SP, Harari S, Martinez FJ, Olschewski H, et al. Pulmonary hypertension in chronic lung disease and hypoxia. Eur Respir J. 2019;53:1801914. - PMC - PubMed