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Association Between Systemic and Pulmonary Vascular Dysfunction in COPD.

Lucilla Piccari¹, Roberto Del Pozo¹, Isabel Blanco^1,2

¹Department of Pulmonary Medicine, Hospital Clínic, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.

International Journal of Chronic Obstructive Pulmonary Disease

|September 9, 2020

Summary

Systemic artery dysfunction is common in chronic obstructive pulmonary disease (COPD), with or without pulmonary vascular disease (PVD). COPD patients with PVD exhibit greater arterial stiffness and endothelial dysfunction, indicating linked vascular issues.

Keywords:

COPD cardiovascular diseases emphysema pulmonary circulation and pulmonary hypertension

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Published on: January 14, 2014

Area of Science:

Cardiovascular Medicine
Pulmonology
Vascular Biology

Background:

Chronic obstructive pulmonary disease (COPD) is linked to increased cardiovascular risk due to endothelial dysfunction and arterial stiffness.
Pulmonary vascular disease (PVD) is prevalent in COPD, but its association with systemic vascular dysfunction requires further investigation.

Purpose of the Study:

To evaluate the association between pulmonary vascular disease (PVD) and systemic vascular dysfunction in patients with chronic obstructive pulmonary disease (COPD).

Main Methods:

108 subjects were grouped into non-smoking controls, smoking controls, COPD without PVD, and COPD with PVD.
Systemic artery endothelial function (flow-mediated dilation, FMD) and arterial stiffness (pulse wave velocity, PWV) were assessed.
PVD was diagnosed via right heart catheterization or echocardiography; biomarkers of inflammation and endothelial damage were measured.

Main Results:

Endothelial dysfunction (lower FMD) was observed in COPD patients, with or without PVD, compared to non-smoking controls.
Increased arterial stiffness (higher PWV) was found in COPD patients with PVD compared to controls and to COPD patients without PVD.
FMD and PWV correlated with lung function parameters (FEV1, DLCO) and pulmonary artery pressure (PAP).

Conclusions:

Endothelial dysfunction of systemic arteries is common in COPD, regardless of PVD status.
COPD patients with PVD demonstrate enhanced systemic arterial stiffness and endothelial dysfunction.
Findings suggest a link between vascular impairment in both pulmonary and systemic circulation in a subset of COPD patients.