Key result
Acute exacerbations of COPD were associated with significantly impaired endothelial function compared to recovery or stable conditions (SMD -0.87; 95% CI -1.19 to -0.55).
Why the study?
High cardiovascular risk in COPD is amplified during acute exacerbations, and endothelial dysfunction has been suggested as a potential pathogenetic mechanism.
Does acute COPD exacerbation worsen endothelial function compared to stable condition in adult patients with COPD?
Meta-Analysis
Does acute COPD exacerbation worsen endothelial function compared to stable condition in adult patients with COPD?
Standardized Mean Difference: -0.87 (95% CI -1.19–-0.55)
Endothelial dysfunction is significantly worsened during acute exacerbations of COPD, which may contribute to the heightened cardiovascular risk observed during these events.
Worsened endothelial function during AECOPD heightens acute CV risk; supports closer monitoring and leaves open vascular-targeted interventions.
Chronic obstructive pulmonary disease (COPD) is characterized by high cardiovascular risk, which is further amplified during acute COPD exacerbations (AECOPD). Endothelial dysfunction has been previously suggested as one of the potential pathogenetic mechanisms. In order to study the effects of AECOPD on endothelial function assessed by available functional methods, we performed a literature search involving Pubmed and Scopus databases. Eligible studies were those that included adult patients with COPD and evaluated endothelial damage via semi-invasive or noninvasive functional methods, during AECOPD and after recovery or in stable condition. Newcastle-Ottawa Scale was applied to evaluate the quality of retrieved studies. Endothelial function was significantly impaired during AECOPD compared to recovery/stable condition (SMD: −0.87, 95%CI [−1.19, −0.55]). Patients during AECOPD presented a significantly worse response in endothelium-dependent (flow-mediated dilatation WMD: −2.59, 95%CI [−3.75, −1.42]) and independent vasodilation (nitroglycerine-mediated dilatation WMD: −3.13, 95%CI [−5.18, −1.09]) compared to recovery. Sensitivity analyses confirmed the above results. In conclusion, endothelium-dependent and independent vasodilation is worse during AECOPD compared to the stable condition. Endothelial dysfunction could play a role in the high cardiovascular risk during AECOPD.
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Theodorakopoulou et al. (2021) conducted a meta-analysis in Chronic obstructive pulmonary disease (COPD). Acute exacerbations of COPD (AECOPD) vs. Recovery or stable condition was evaluated on Endothelial function (SMD -0.87, 95% CI -1.19 to -0.55). Acute exacerbations of COPD were associated with significantly impaired endothelial function compared to recovery or stable conditions (SMD -0.87; 95% CI -1.19 to -0.55).
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