Vascular dysfunction and systemic inflammation in patients with COPD

Introduction: We studied the differences between COPD patients and healthy controls in order to establish an etiological association between systemic inflammation and vascular endothelial dysfunction. Materials and methods: Observational case-control study involving COPD patients and controls without COPD or cardiovascular history. All of them were tested for serum and urinary markers. Peripheral arterial tonometry by oscillometric sphygmomanometer (ENDO-PAT 2000) was used to measure endothelial dysfunction and arterial stiffness values (Reactive Hyperemia Index-RHI and Augmentation Index-AI). We also performed anthropometric and pulmonary function measurements. Results: This study involved 52 persons (33 COPD patients and 17 healthy controls). Mean age: 59 in the COPD group and 52,5 in the controls (p =0, 07). Mean BMI: 25, 4 and 26, 2 respectively (p= 0,55). Mean FEV1 value: 74, 3% and mean CO diffusion test value: 74, 6%. The results for the serum and urinary markers (Mann-Whitney test) comparison with median and quartiles were the following: CRP (COPD 0,69, controls 0,60, p=0,06), leucocytes (COPD 8500, controls 6800, p= 0,001), D-dimer (COPD 289, controls 242, p= 0,16), BNP (COPD 36,3, controls 119,6, p= 0,41), fibrinogen (COPD 416, controls 327, p= 0,01) and microalbuminuria (COPD 11,0, controls 3,0, p= 0,03). No statistically significant differences in vascular endothelial dysfunction (RHI, COPD 2,2, control 1,8, p= 0,1) neither in arterial stiffness (AI, COPD 22, controls 34, p= 0,4) were found. Conclusions: Cardiovascular risk increase in COPD patients can be predicted by measuring serum and urinary markers. Tonometrical measurements of endothelial dysfunction and arterial stiffness were unpredictive.