Objective Prior work has described the relationship between pulmonary vascular pruning on CT scan and metrics of right heart dysfunction in smokers. In this analysis we sought to look at pruning on a lobar level as well as examine the effect of the arterial and venous circulation on this association. Methods Automated vessel segmentation applied to non-contrast CT scans from the COPDGene study in 24 subjects with cardiac MRIs was used to create a blood volume distribution profile. These vessels were then manually tracked to their origin and characterized as artery or vein. Results Assessment of pruning on a lobar level revealed associations between pruning and right ventricular function previously not observed n a global level. The right ventricular mass index (RVMI) , the right ventricular end systolic volume index (RVESVI) and pulmonary arterial to aorta ratio (PA/A) were associated with both arterial and venous pruning, whereas right ventricular ejection fraction was associated with only arterial pruning. Conclusions Lobar assessment as well as segmentation of the parenchymal vasculature into arterial and venous component provide additional information about the relationship between loss of vasculature on CT scans and right ventricular dysfunction.

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