What does this research mean for the field?

Cardiopulmonary structural remodeling in COPD exhibits gender dimorphism, with males predominantly showing hyperinflation-related cardiac compression (pseudomicrocardia) and females showing more prominent vascular alterations. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The aim is to evaluate structural changes in cardiopulmonary tissues in COPD and their relationship with functional severity.

March 19, 2026Open Access

Complementary assessment of cardiopulmonary morphometric changes in COPD using 3D multidetector computed tomography: relationship with functional indices

Key Points

The aim is to evaluate structural changes in cardiopulmonary tissues in COPD and their relationship with functional severity.
Retrospective analysis of 114 participants (58 COPD patients, 56 controls)
Evaluation of lung and heart volumes using 3D multidetector computed tomography
Assessment of pulmonary function tests and clinical scores (CAT, mMRC)
Measurement of vascular diameters on axial CT images
Male COPD patients have significantly higher right lung volumes than controls (p < 0.01)
Lower right heart ventricular volumes observed in males (p < 0.05), indicating 'pseudomicrocardia'
Female COPD patients show higher pulmonary artery diameters (p = 0.050)
Smoking pack-years correlate with increased total lung volume (p < 0.05)
RV volume increases notably in the GOLD E subgroup, indicating higher symptom burden.

Abstract

This study aimed to quantitatively evaluate the structural remodeling of cardiopulmonary tissues in Chronic Obstructive Pulmonary Disease (COPD) using three-dimensional multidetector computed tomography (3D-MDCT) and to investigate the relationship between these morphometric changes and functional disease severity across genders. A retrospective analysis was performed on 114 participants (58 stable COPD patients and 56 age-matched controls). Pulmonary function tests (PFT), Global Initiative for Chronic Obstructive Lung Disease (GOLD) staging, and clinical scores (CAT, mMRC) were recorded. Right/left lung volumes (RLV, LLV) and heart ventricular volumes (RV, LV) were measured via 3D-Slicer software. Major vascular diameters (VCS, VCI, PA) were assessed on axial CT sections. Distinct gender-related structural patterns were identified. Male COPD patients exhibited significantly higher right lung volumes compared to controls (p < 0.01), which showed a strong negative correlation with the Forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) ratio, indicating hyperinflation-driven remodeling. Conversely, male patients demonstrated significantly lower right heart ventricular volumes (RV) (p < 0.05), supporting the “pseudomicrocardia” effect where hyperinflation mechanically restricts cardiac filling. In female COPD patients, pulmonary artery (PA) diameters were higher than in controls, showing a borderline significant trend (p = 0.050), while total lung volume negatively correlated with Vena Cava Superior (VCS) diameter (p < 0.05). Across both genders, smoking pack-years were identified as a significant independent predictor of increased total lung volume (p < 0.05). Although morphometric parameters did not differ significantly across GOLD stages, RV volume was notably increased in the GOLD E subgroup, reflecting higher symptom burden. 3D-MDCT provides a quantitative and objective assessment of secondary cardiopulmonary structural changes that may accompany COPD. The study suggests a potential gender dimorphism in structural remodeling; while hyperinflation-related cardiac compression (pseudomicrocardia) appears more notable in males, vascular alteration trends seem more prominent in females. These morphometric insights may serve as a valuable complementary tool to spirometry, especially in monitoring disease progression and evaluating systemic structural effects in clinical practice.

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