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Determinants of endothelial function in patients with COPD


Clarenbach, Christian F; Senn, Oliver; Sievi, Noriane A; Camen, Giovanni; van Gestel, Arnoldus JR; Rossi, Valentina A; Puhan, Milo A; Thurnheer, Robert; Russi, Erich W; Kohler, Malcolm (2013). Determinants of endothelial function in patients with COPD. European Respiratory Journal, 42(5):1194-1204.

Abstract

COPD is associated with increased cardiovascular mortality. Endothelial dysfunction may underpin this association. This cross-sectional study aims to determine the impact of airflow obstruction, systemic inflammation, oxidative stress, sympathetic activation, hypoxemia and physical activity on endothelial function in COPD.In stable COPD patients assessments of endothelial function by flow-mediated dilatation (FMD), cardiovascular risk (Pocock-score), airflow obstruction (FEV1), systemic inflammation (hsCRP, Interleukin-6), oxidative stress (malondialdehyde), sympathetic activation (baroreflex-sensitivity), hypoxemia (Pa,O2), hypercapnia (Pa,CO2), physical activity (steps per day) and exercise capacity (6-minutes walking distance) were performed. Associations between FMD and potential determinants were assessed in univariate and multivariate analysis.106 patients (35% GOLD stage I/II, 25% III, 40% IV) were included. In multivariate analysis FEV1 was positively associated with FMD, independent of other significant FMD determinants from univariate analysis (gender, smoking, combined inhaled long-acting β-adrenergic and steroid medication, heart rate, baroreflex-sensitivity, Pa,CO2) and adjusted for potential confounders (cardiovascular risk, age). In addition, the FMD and FEV1 association was modified by physical activity.The findings of this study demonstrate that the severity of airflow obstruction is a significant determinant of endothelial function in patients with COPD. A high level of physical activity seems to have a favourable effect on this association.

Abstract

COPD is associated with increased cardiovascular mortality. Endothelial dysfunction may underpin this association. This cross-sectional study aims to determine the impact of airflow obstruction, systemic inflammation, oxidative stress, sympathetic activation, hypoxemia and physical activity on endothelial function in COPD.In stable COPD patients assessments of endothelial function by flow-mediated dilatation (FMD), cardiovascular risk (Pocock-score), airflow obstruction (FEV1), systemic inflammation (hsCRP, Interleukin-6), oxidative stress (malondialdehyde), sympathetic activation (baroreflex-sensitivity), hypoxemia (Pa,O2), hypercapnia (Pa,CO2), physical activity (steps per day) and exercise capacity (6-minutes walking distance) were performed. Associations between FMD and potential determinants were assessed in univariate and multivariate analysis.106 patients (35% GOLD stage I/II, 25% III, 40% IV) were included. In multivariate analysis FEV1 was positively associated with FMD, independent of other significant FMD determinants from univariate analysis (gender, smoking, combined inhaled long-acting β-adrenergic and steroid medication, heart rate, baroreflex-sensitivity, Pa,CO2) and adjusted for potential confounders (cardiovascular risk, age). In addition, the FMD and FEV1 association was modified by physical activity.The findings of this study demonstrate that the severity of airflow obstruction is a significant determinant of endothelial function in patients with COPD. A high level of physical activity seems to have a favourable effect on this association.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Integrative Human Physiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Pneumology
04 Faculty of Medicine > University Hospital Zurich > Institute of General Practice
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Language:English
Date:2013
Deposited On:10 Jun 2013 07:11
Last Modified:05 Apr 2016 16:48
Publisher:European Respiratory Society
ISSN:0903-1936
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1183/09031936.00144612
PubMed ID:23429917

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