Systemic vascular function in chronic obstructive pulmonary disease

Introduction: Patients with chronic obstructive pulmonary disease (COPD) have increased risk of cardiovascular disease (CVD). Arterial stiffness and endothelial dysfunction are associated with the risk of CVD. Previous studies have shown increased stiffness and endothelial dysfunction in systemic arteries, in separated cohorts of COPD patients. The study was addressed to assess endothelial function and arterial compliance in the same cohort of COPD patients, and to evaluate the influence of associated pulmonary hypertension (PH). Methods: 33 control subjects with normal pulmonary function (55±10y; 49% men; FEV1 113±15 %pred); 41 COPD patients (63±7y; 78% men; FEV1 52±18 %pred); and 17 COPD patients with echocardiographic PH (62±7y; 88% men; FEV1 32±15 %pred) were studied. Arterial compliance was assessed by means of the pulse wave velocity (PWV) and the augmentation index (AI). Endothelial function estimated with maximum flow-mediated brachial artery dilatation (FMD) by high-resolution ultrasound. Results: In COPD patients, PWV was inversely related to FEV1 (r=-0.34; p=0.01). No correlation was observed between PWV and FMD in COPD. Conclusion: COPD is associated with both arterial stiffness and endothelial dysfunction of systemic vessels, with greater impairment in patients with more severe disease and/or pulmonary hypertension. Supported by a grant from FIS PS09/00536. JGL is recipient of PFIS grant from ISCIII.