Back to Search
Start Over
Systemic vascular dysfunction is associated with emphysema burden in mild COPD
- Source :
- Respiratory medicine. 136
- Publication Year :
- 2017
-
Abstract
- Background Cardiovascular diseases play a major role in morbidity and mortality in the earlier stages of COPD. We hypothesized that systemic vascular dysfunction would be present even in patients who are currently considered at “low-risk” for negative cardiovascular outcomes, i.e., those with largely preserved FEV1, few exacerbations and only mild burden of respiratory symptoms (GOLD spirometric grade 1, clinical group A). Methods 16 patients (FEV1 = 86 ± 13%) and 16 age- and gender-matched controls underwent measurements of: a) central arterial stiffness by pulse wave velocity, b) brachial flow-mediated dilation and c) forearm muscle oxygenation by near-infrared spectroscopy. Computed tomography quantified emphysema (% of low attenuation areas (LAA)) and airway disease. Results Patients and controls were well matched for key clinical variables including co-morbidities burden. Thirteen patients presented with more than 5% LAA: emphysema extension was negatively related to transfer factor for carbon monoxide (TLCO) (r = −0.63; p = .01). Compared to controls, patients had higher central arterial stiffness, lower normalized (to shear stress) flow-mediated dilation, delayed time to peak flow-mediated dilation and poorer muscle oxygenation (p Conclusion Systemic vascular dysfunction is present in the earlier stages of COPD, particularly in patients with greater emphysema burden and low TLCO. Regardless FEV1, patients showing those structural and functional abnormalities might be at higher risk of negative events thereby deserving closer follow-up for early detection of cardiovascular disease.
- Subjects :
- Pulmonary and Respiratory Medicine
Male
medicine.medical_specialty
Vital Capacity
Disease
030204 cardiovascular system & hematology
Pulse Wave Analysis
03 medical and health sciences
Pulmonary Disease, Chronic Obstructive
0302 clinical medicine
Vascular Stiffness
DLCO
Risk Factors
Internal medicine
Forced Expiratory Volume
medicine
Humans
Vascular Diseases
Respiratory system
Muscle, Skeletal
Pulse wave velocity
Aged
COPD
business.industry
Oxygenation
Blood flow
Middle Aged
medicine.disease
respiratory tract diseases
Oxygen
Vasodilation
Forearm
030228 respiratory system
Pulmonary Emphysema
Case-Control Studies
Microvessels
Cardiology
Arterial stiffness
Female
business
Tomography, X-Ray Computed
Subjects
Details
- ISSN :
- 15323064
- Volume :
- 136
- Database :
- OpenAIRE
- Journal :
- Respiratory medicine
- Accession number :
- edsair.doi.dedup.....fdd22b3fc138d287dc64879115834c79