• Sophie É Collins, Miranda Kirby, Benjamin M Smith, Wan Tan, Jean Bourbeau, Stephanie Thompson, Sean van Diepen, Dennis Jensen, Sanja Stanojevic, Michael K Stickland, and CanCOLD Collaborative Research Group and the Canadian Respiratory Research Network.
• Division of Pulmonary Medicine, Faculty of Medicine and Dentistry University of Alberta, Edmonton, AB, Canada; Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
• Chest. 2024 Oct 3.

BackgroundAlthough it is generally accepted that aerobic exercise training does not change lung structure or function, some work suggests that greater pulmonary vascular structure and function is associated with higher exercise capacity (peak oxygen consumption [Vo2peak]).Research QuestionIs there a cross-sectional association between the pulmonary vasculature and Vo2peak? We hypothesized that those with higher CT blood vessel volumes and capacity of the lungs for carbon monoxide (Dlco) would have higher Vo2peak, independent of airflow limitation.Study Design And MethodsParticipants from the Canadian Cohort Obstructive Lung Disease (CanCOLD) study were categorized as follows: never smokers with normal spirometry (n = 263), ever smokers with normal spirometry (n = 407), and COPD: individuals with spirometric airflow obstruction (n = 334). Total vessel volume (TVV), volume for vessels < 5 mm2 in cross-sectional area (BV5), and volume for vessels between 5 and 10 mm2 in cross-sectional area (BV5-10) were generated from CT scans and used as indices of pulmonary vascular structure. Dlco was used as an index of pulmonary microvascular function. Vo2peak was evaluated via incremental cardiopulmonary exercise testing.ResultsGeneral linear regression models revealed that even after controlling for FEV1, emphysema severity, and body morphology, Dlco, TVV, BV5, and BV5-10, were independently associated with Vo2peak. Interaction effects were observed between COPD and TVV, BV5, and BV5-10, indicating a weaker association between pulmonary vascular volumes and Vo2peak in COPD.InterpretationOur results suggest that pulmonary vascular structure and Dlco are independently associated with Vo2peak, regardless of severity of airflow limitation and emphysema, suggesting that these associations are not limited to COPD.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

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