Association between CMR-derived pulmonary artery pulse wave velocity and pulmonary risk factors: the multi-ethnic study of atherosclerosis COPD study

PURPOSE: Pulse wave velocity (PWV) is a quantitative marker of arterial stiffness which is widely validated in the systemic circulation. Pulmonary artery (PA) stiffness, as measured by PWV, and its associations with disease, risk factors, and outcomes are largely unestablished. We aimed to assess the association of PA PWV with smoking history. METHODS: This prospective cohort study was conducted among participants enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA) COPD who received cardiac magnetic resonance (CMR). 2-D phase contrast images were acquired to assess flow. PA PWV was assessed using validated semi-automated software for the main, right, and left PA by a single reader. Non-parametric, skewed data were log-transformed as appropriate and univariable, and multivariable linear regression models were used to analyze association of PA PWV and to demographic factors and cardiopulmonary risk. RESULTS: A total of 166 participants were included in this study after excluding for artifacts or incomplete scans. Participants were 65% male, average age 68 ± 7 years, smoked an average of 34 ± 20 pack-years, and 36% had COPD. A unit increase in pack-year was associated with a higher log average PA PWV of 0.007 (p < 0.01). This association persisted after adjustment for demographics, vascular risk factors, COPD stage and ABI. PA PWV was not associated with COPD status. CONCLUSIONS: We demonstrated that a severe smoking history was independently associated with a greater PA PWV. Our study advances the understanding of the mechanisms of cardiopulmonary risk factors and underscores the potential clinical applicability of PA PWV measurement for early disease detection.