help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH

Published ahead of print on June 19, 2009, doi:10.1164/rccm.200903-0414OC

Am. J. Respir. Crit. Care Med., Volume 180, Number 6, September 2009, 513-520

A more recent version of this article appeared on September 15, 2009
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
200903-0414OCv1
180/6/513    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Google Scholar
Right arrow Articles by Maclay, J.
Right arrow Articles by MacNee, W.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Maclay, J.
Right arrow Articles by MacNee, W.

Submitted on March 16, 2009
Accepted on June 19, 2009

Vascular dysfunction in chronic obstructive pulmonary disease

John Maclay1, David A McAllister1, Nicholas L Mills2, Finny Paterson3, Christopher A Ludlam4, Ellen M Drost1, David E Newby2, and William MacNee1*

1 Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom, 2 Cardiovascular Research, University of Edinburgh, Edinburgh, United Kingdom, 3 Clinical Research Facility, Royal Infirmary Edinburgh, Edinburgh, United Kingdom, 4 Department of Haematology, Royal Infirmary Edinburgh, Edinburgh, United Kingdom

* To whom correspondence should be addressed. E-mail: wmacnee{at}staffmail.ed.ac.uk.

Rationale: Cardiovascular disease is a major cause of morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD), which may in part be attributable to abnormalities of systemic vascular function. It is unclear whether such associations relate to the presence of COPD or prior smoking habit. Objectives: To undertake a comprehensive assessment of vascular function in patients with COPD and healthy controls matched for smoking history. Methods: Eighteen men with COPD were compared with 17 healthy male controls matched for age and lifetime cigarette smoke exposure. Participants were free from clinically evident cardiovascular disease. Measurements and main results: Pulse wave velocity (PWV) and pulse wave analysis were measured via applanation tonometry at carotid, radial and femoral arteries. Blood flow was measured in both forearms using venous occlusion plethysmography during intra-brachial infusion of endothelium-dependent vasodilators (bradykinin, 100-1000 pmol/min; acetylcholine, 5-20 µg/min) and endothelium-independent vasodilators (sodium nitroprusside, 2-8 µg/min; verapamil, 10-100 µg/min). Tissue plasminogen activator (t-PA) was measured in venous plasma before and during bradykinin infusions. Patients with COPD have greater arterial stiffness (PWV, 11±2 vs 9±2 m/s; p=0.003: augmentation index, 27±10 vs 21±6 %, p=0.028), but there were no differences in endothelium-dependent and –independent vasomotor function or bradykinin-induced endothelial t-PA release (p>0.05 for all). Conclusions: COPD is associated with increased arterial stiffness independent of cigarette smoke exposure. However, this abnormality is not explained by systemic endothelial dysfunction. Increased arterial stiffness may represent the mechanistic link between COPD and the increased risk of cardiovascular disease associated with this condition.


Key words: pulmonary disease, chronic obstructive • cardiovascular diseases • arterial stiffness • endothelial function




This article has been cited by other articles:


Home page
Am. J. Respir. Crit. Care Med.Home page
O. C. Burghuber and A. Valipour
Knowing Chronic Obstructive Pulmonary Disease by Heart: Cumulating Evidence of Systemic Vascular Dysfunction
Am. J. Respir. Crit. Care Med., September 15, 2009; 180(6): 487 - 488.
[Full Text] [PDF]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2009 American Thoracic Society
  ATS Quiz on Sleep Study Tracings