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Assessments of endothelial function and arterial stiffness are reproducible in patients with COPD
Paula Rodriguez-Miguelez1, Nichole Seigler1, Leon Bass2
1Division of Clinical and Translational Sciences, Georgia Prevention Institute, Georgia Regents University, Augusta, GA, USA.
Insights
This study confirms that measures of endothelial function and arterial stiffness are reproducible within and between days for patients with chronic obstructive pulmonary disease (COPD). These findings support their use in clinical research for COPD cardiovascular risk assessment.
Area of Science:
- Cardiovascular Research
- Pulmonary Medicine
- Biomedical Engineering
Background:
- Patients with chronic obstructive pulmonary disease (COPD) face elevated cardiovascular disease (CVD) risk.
- Non-invasive assessments of endothelial dysfunction and arterial stiffness offer mechanistic insights into CVD risk in COPD.
- Reproducibility of these non-invasive measures in COPD patients requires investigation.
Purpose of the Study:
- To assess the within-day reproducibility of endothelial function and arterial stiffness measurements in COPD patients.
- To evaluate the between-day reproducibility of endothelial function and arterial stiffness measurements in COPD patients.
Main Methods:
- Seventeen COPD patients (age 47-75) underwent three assessments of endothelial function (flow-mediated dilation) and arterial stiffness (augmentation index, pulse wave velocity).
- Within-day assessments (A and B) were 3 hours apart; between-day assessments (B and C) were at least 7 days apart.
- Reproducibility was analyzed using paired t-tests, coefficients of variation, intra-class correlation, Pearson's correlations, and Bland-Altman plots.
Main Results:
- All six within-day criteria were met for both endothelial function and arterial stiffness outcomes.
- Six of six between-day criteria were met for baseline/peak diameter, augmentation index, and pulse wave velocity.
- Five of six between-day criteria were met for flow-mediated dilation.
Conclusions:
- The study demonstrates reliable within-day reproducibility for endothelial function and arterial stiffness in COPD patients.
- Evidence supports the between-day reproducibility of these vascular measures in the COPD population.
- These findings validate the use of these non-invasive techniques for assessing cardiovascular risk in COPD.
Background:
Elevated cardiovascular disease risk is observed in patients with COPD. Non-invasive assessments of endothelial dysfunction and arterial stiffness have recently emerged to provide mechanistic insight into cardiovascular disease risk in COPD; however, the reproducibility of endothelial function and arterial stiffness has yet to be investigated in this patient population.
Objectives:
This study sought to examine the within-day and between-day reproducibility of endothelial function and arterial stiffness in patients with COPD.
Methods:
Baseline diameter, peak diameter, flow-mediated dilation, augmentation index, augmentation index at 75 beats per minute, and pulse wave velocity were assessed three times in 17 patients with COPD (six males, eleven females, age range 47-75 years old; forced expiratory volume in 1 second =51.5% predicted). Session A and B were separated by 3 hours (within-day), whereas session C was conducted at least 7 days following session B (between-day). Reproducibility was assessed by: 1) paired t-tests, 2) coefficients of variation, 3) coefficients of variation prime, 4) intra-class correlation coefficient, 5) Pearson's correlations (r), and 6) Bland-Altman plots. Five acceptable assessments were required to confirm reproducibility.
Results:
Six out of six within-day criteria were met for endothelial function and arterial stiffness outcomes. Six out of six between-day criteria were met for baseline and peak diameter, augmentation index and pulse wave velocity, whereas five out of six criteria were met for flow-mediated dilation.
Conclusion:
The present study provides evidence for within-day and between-day reproducibility of endothelial function and arterial stiffness in patients with COPD.
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