[Clinical and diagnostic significance of intima-media thickness in chronic obstructive pulmonary disease]

To estimate changes in common carotid artery (CCA) intima-media thickness (TIM) in patients with the isolated form of chronic obstructive pulmonary disease (COPD) or that concurrent with coronary heart disease (CHD) and arterial hypertension (AH).

Carotid duplex scanning, echocardiography, electrocardiogram (ECG) Holter monitoring, and spirometry were performed in 150 patients with COPD, COPD + AH, or COPD + CHD and in 33 apparently healthy men and women aged 39-77 years.

An increase in TIM (more than 0.9 mm) was determined in 54.5% of the patients with isolated COPD, in 76.7% of those with COPD + CHD, and in 68.2% of those with COPD + AH. The correlation coefficient between TIM and age varied from 0.3 to 0.49 (controls 0.66) whereas that with the degree of bronchial obstruction (forced expiratory volume in one second) was statistically insignificant. In isolated COPD, the increase in CCA TIM was determined from the presence of right ventricular hypertrophy. Hemodynamic relevant supraventricular and ventricular premature beats were more frequently recorded in the presence of increased TIM and only in the COPD + AH group. Changed heart rate variability with the predominance of sympathetic tone over parasympathetic one was observed in all the patients with COPD and increased TIM.

The widespread increase in CCA TIM in patients with COPD shows the need for carotid duplex scanning in this contingent of patients, primarily in persons over the age of 50 years with Stage III--IV COPD concurrent with CHD or AH.