RATIONALE: Chronic obstructive pulmonary disease (COPD) is associated with an increased risk of cardiovascular events and osteoporosis. Increased arterial stiffness is an independent predictor of cardiovascular disease. OBJECTIVES: We tested the hypothesis that patients with COPD would have increased arterial stiffness, which would be associated with osteoporosis and systemic inflammation. METHODS: We studied 75 clinically stable patients with a range of severity of airway obstruction and 42 healthy smoker or ex-smoker control subjects, free of cardiovascular disease. All subjects underwent spirometry, measurement of aortic pulse wave velocity (PWV) and augmentation index, dual-energy X-ray absorptiometry, and blood sampling for inflammatory mediators. MEASUREMENTS AND MAIN RESULTS: Mean (SD) aortic PWV was greater in patients, 11.4 (2.7) m/s, than in control subjects, 8.95 (1.7) m/s, p < 0.0001. Inflammatory mediators and augmentation index were also greater in patients. Patients with osteoporosis at the hip had a greater aortic PWV, 13.1 (1.8) m/s, than those without, 11.2 (2.7) m/s, p < 0.05. In patients, aortic PWV was related to age (r = 0.63, p < 0.0001) and log(10) IL-6 (r = 0.31, p < 0.01), and inversely to FEV(1) (r = -0.34, p < 0.01). The strongest predictors of aortic PWV in all subjects were age (p < 0.0001), percent predicted FEV(1) (p < 0.05), mean arterial pressure (p < 0.05), and log(10) IL-6 (p < 0.05). CONCLUSIONS: Increased arterial stiffness was related to the severity of airflow obstruction and may be a factor in the excess risk for cardiovascular disease in COPD. The increased aortic PWV in patients with osteoporosis and the association with systemic inflammation suggest that age-related bone and vascular changes occur prematurely in COPD.
RATIONALE: Chronic obstructive pulmonary disease (COPD) is associated with an increased risk of cardiovascular events and osteoporosis. Increased arterial stiffness is an independent predictor of cardiovascular disease. OBJECTIVES: We tested the hypothesis that patients with COPD would have increased arterial stiffness, which would be associated with osteoporosis and systemic inflammation. METHODS: We studied 75 clinically stable patients with a range of severity of airway obstruction and 42 healthy smoker or ex-smoker control subjects, free of cardiovascular disease. All subjects underwent spirometry, measurement of aortic pulse wave velocity (PWV) and augmentation index, dual-energy X-ray absorptiometry, and blood sampling for inflammatory mediators. MEASUREMENTS AND MAIN RESULTS: Mean (SD) aortic PWV was greater in patients, 11.4 (2.7) m/s, than in control subjects, 8.95 (1.7) m/s, p < 0.0001. Inflammatory mediators and augmentation index were also greater in patients. Patients with osteoporosis at the hip had a greater aortic PWV, 13.1 (1.8) m/s, than those without, 11.2 (2.7) m/s, p < 0.05. In patients, aortic PWV was related to age (r = 0.63, p < 0.0001) and log(10) IL-6 (r = 0.31, p < 0.01), and inversely to FEV(1) (r = -0.34, p < 0.01). The strongest predictors of aortic PWV in all subjects were age (p < 0.0001), percent predicted FEV(1) (p < 0.05), mean arterial pressure (p < 0.05), and log(10) IL-6 (p < 0.05). CONCLUSIONS: Increased arterial stiffness was related to the severity of airflow obstruction and may be a factor in the excess risk for cardiovascular disease in COPD. The increased aortic PWV in patients with osteoporosis and the association with systemic inflammation suggest that age-related bone and vascular changes occur prematurely in COPD.
Authors: Gary F Mitchell; Germaine C Verwoert; Kirill V Tarasov; Aaron Isaacs; Albert V Smith; Ernst R Rietzschel; Toshiko Tanaka; Yongmei Liu; Afshin Parsa; Samer S Najjar; Kevin M O'Shaughnessy; Sigurdur Sigurdsson; Marc L De Buyzere; Martin G Larson; Mark P S Sie; Jeanette S Andrews; Wendy S Post; Francesco U S Mattace-Raso; Carmel M McEniery; Gudny Eiriksdottir; Patrick Segers; Ramachandran S Vasan; Marie Josee E van Rijn; Timothy D Howard; Patrick F McArdle; Abbas Dehghan; Elizabeth S Jewell; Stephen J Newhouse; Sofie Bekaert; Naomi M Hamburg; Anne B Newman; Albert Hofman; Angelo Scuteri; Dirk De Bacquer; Mohammad Arfan Ikram; Bruce M Psaty; Christian Fuchsberger; Matthias Olden; Louise V Wain; Paul Elliott; Nicholas L Smith; Janine F Felix; Jeanette Erdmann; Joseph A Vita; Kim Sutton-Tyrrell; Eric J G Sijbrands; Serena Sanna; Lenore J Launer; Tim De Meyer; Andrew D Johnson; Anna F C Schut; David M Herrington; Fernando Rivadeneira; Manuela Uda; Ian B Wilkinson; Thor Aspelund; Thierry C Gillebert; Luc Van Bortel; Emelia J Benjamin; Ben A Oostra; Jingzhong Ding; Quince Gibson; André G Uitterlinden; Gonçalo R Abecasis; John R Cockcroft; Vilmundur Gudnason; Guy G De Backer; Luigi Ferrucci; Tamara B Harris; Alan R Shuldiner; Cornelia M van Duijn; Daniel Levy; Edward G Lakatta; Jacqueline C M Witteman Journal: Circ Cardiovasc Genet Date: 2011-11-08
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