Determinants of arterial stiffness in COPD

BMC Pulmonary Medicine

Mark T Dransfield⁴  John R Cockcroft¹  Jubal R Watts³  Hrudaya Nath³  James Michael Wells²  Adam G Cole²  Surya P Bhatt² 

[1] Department of Cardiology, Wales Heart Research Institute, University Hospital, Cardiff, UK;Lung Health Center, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA;Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA;The Birmingham VA Medical Center, Birmingham, AL, USA

关键词: Cardiovascular;    Arterial calcification;    Arterial stiffness;    COPD;   

Others  :  865460
DOI  :  10.1186/1471-2466-14-1

 received in 2013-07-07, accepted in 2013-12-31,  发布年份 2014

【 摘 要 】

Background

Cardiovascular morbidity and mortality is high in patients with chronic obstructive pulmonary disease (COPD) and arterial stiffness is a potentially modifiable risk factor with added predictive value beyond that obtained from traditional risk factors. Arterial stiffness has been the target of pharmacologic and exercise interventions in patients with COPD, but the effects appear limited to those patients with more significant elevations in arterial stiffness. We aimed to identify predictors of increased arterial stiffness in a cohort with moderate to severe COPD.

Methods

Aortic pulse wave velocity (aPWV) was measured in subjects with moderate to severe COPD enrolled in a multicenter randomized controlled trial. Subjects were categorized into quartiles based on aPWV values and factors affecting high arterial stiffness were assessed. Multivariate models were created to identify independent predictors of high aPWV, and cardiovascular disease (CVD).

Results

153 patients were included. Mean age was 63.2 (SD 8.2) years and mean FEV₁ was 55.4 (SD 15.2) % predicted. Compared to the quartile with the lowest aPWV, subjects in the highest quartile were older, had higher systolic blood pressure (SBP), were more likely to be current smokers, and had greater burden of thoracic aortic calcification. On multivariate analyses, age (adjusted OR 1.14, 95%CI 1.05 to 1.25, p = 0.003) and SBP (adjusted OR 1.06, 95% CI 1.02 to 1.09, p = 0.001) were independent predictors of elevated aPWV. Body mass index, therapy with cholesterol lowering medications and coronary calcification were independent predictors of CVD.

Conclusions

Elevated arterial stiffness in patients with COPD can be predicted using age, blood pressure and thoracic aortic calcification. This will help identify subjects for enrollment in clinical trials using aPWV for assessing the impact of COPD therapies on CV outcomes.

Trial registration

Clinicaltrials.gov NCT00857766

【 授权许可】

   
2014 Bhatt et al.; licensee BioMed Central Ltd.

【 图 表 】

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