Endothelial dysfunction and systemic inflammation during acute exacerbations of COPD

Background: Endothelial dysfunction is a possible link between increased cardiovascular mortality and systemic inflammation in patients with COPD. Acute exacerbations of COPD might be accompanied by deteriorated endothelial function. Endothelial dysfunction correlates with circulating inflammatory markers in stable COPD and represents an increased risk for cardiovascular morbidity in COPD patients during acute exacerbations. Aim: The aim of this study was to assess the endothelial function and systemic inflammation during acute exacerbation of COPD. Methods: We enrolled 37 patients admitted to hospital due to an acute exacerbation of COPD and the control group consists of 35 healthy smokers. In both groups were determined ET-1 and vWF as a marker of endothelial dysfunction and CRP, leukocyte and fibrinogen as markers of systemic inflammation. Results: The patient and control groups were similar in terms of age, gender and comorbidity. During the acute exacerbations patients showed a median CRP of 24.0 (10.2-95.5), leukocytes of 9.5 (7.2-14.0), fibrinogen 5.1 (4.2-7.7). ET-1 3.47± 1.15 and vWF 238.1 (194.6-293.2) indicating severe endothelial dysfunction. The measurements of systemic inflammatory markers and endothelial dysfunction markers in COPD patient group were significantly higher than in the control group (ET 1 p Conclusion: Acute COPD exacerbation is associated with significant worsening endothelial function, increasing the risk for cardiovascular morbidity. Furthermore, acute exacerbations deteriorate endothelial function in COPD, probably via aggravation of systemic inflammation.