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Arterial Stiffness Is Independently Associated with Emphysema Severity in Patients with Chronic Obstructive Pulmonary Disease

Authors :
Nicholas L. Mills
David E. Newby
Joy J. Miller
Grant Mair
John D. Maclay
David A. McAllister
William MacNee
David E. Anderson
John T. Murchison
Source :
American Journal of Respiratory and Critical Care Medicine. 176:1208-1214
Publication Year :
2007
Publisher :
American Thoracic Society, 2007.

Abstract

Rationale: More patients with chronic obstructive pulmonary disease (COPD) die of cardiovascular causes than of respiratory causes, and patients with COPD have increased morbidity and mortality from stroke and coronary heart disease. Arterial stiffness independently predicts cardiovascular risk, is associated with atheromatous plaque burden, and is increased in patients with COPD compared with control subjects matched for cardiovascular risk factors. Elastin fragmentation and changes in collagen are found in the connective tissue of both emphysematous lungs and stiff arteries, but it is not known whether the severity of arterial stiffness in patients with COPD is associated with the severity of emphysema. Objectives: To identify whether the extent of arterial stiffness is associated with emphysema severity. Methods: We performed a cross-sectional study in 157 patients with COPD. Measurements and Main Results: We measured pulse wave velocity (a validated measure of arterial stiffness), blood pressure, smoking pack-years, glucose, cholesterol, and C-reactive protein in 157 patients with COPD. We assessed emphysema using quantitative computed tomography scanning in a subgroup of 73 patients. We found that emphysema severity was associated with arterial stiffness (r = 0.471, P < 0.001). The association was independent of smoking, age, sex, FEV1% predicted, highly sensitive C-reactive protein and glucose concentrations, cholesterol–high-density lipoprotein ratio, and pulse oximetry oxygen saturations. Conclusions: Emphysema severity is associated with arterial stiffness in patients with COPD. Similar pathophysiological processes may be involved in both lung and arterial tissue and further studies are now required to identify the mechanism underlying this newly described association.

Details

ISSN :
15354970 and 1073449X
Volume :
176
Database :
OpenAIRE
Journal :
American Journal of Respiratory and Critical Care Medicine
Accession number :
edsair.doi.dedup.....511e08dab71fede811acc152fcf483e8
Full Text :
https://doi.org/10.1164/rccm.200707-1080oc