Key result
COPD is linked to ~10% greater systemic arterial intimal thickening versus smoking controls.
Why the study?
COPD is associated with subclinical systemic atherosclerosis and pulmonary vascular remodelling, but differences in intimal thickening between COPD subjects and smokers were not well defined.
Does COPD associate with greater systemic and pulmonary vascular remodelling compared to smoking alone in subjects undergoing lung resection?
Cross-Sectional (n=42)
Blinded observers
No
Does COPD associate with greater systemic and pulmonary vascular remodelling compared to smoking alone in subjects undergoing lung resection?
Absolute Event Rate: 15.6% vs 14.2%
p-value: p=0.038
COPD is associated with greater intimal thickening in both systemic and pulmonary arteries compared to smoking alone, highlighting a systemic vascular impact of the disease.
COPD-associated vascular remodeling may extend beyond smoking; hypothesis-generating and requires prospective studies before clinical adoption.
BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is associated with subclinical systemic atherosclerosis and pulmonary vascular remodelling characterized by intimal hyperplasia and luminal narrowing. We aimed to determine differences in the intimal thickening of systemic and pulmonary arteries in COPD subjects and smokers. Secondary aims include comparisons with a non-smokers group; determining the clinical variables associated with systemic and pulmonary intimal thickening, and the correlations between systemic and pulmonary remodelling changes. METHODS: All consecutive subjects undergoing lung resection were included and divided into 3 groups: 1) COPD, 2) smokers, and 3) non-smokers. Sections of the 5th intercostal artery and muscular pulmonary arteries were measured by histo-morphometry. Four parameters of intimal thickening were evaluated: 1) percentage of intimal area (%IA), 2) percentage of luminal narrowing, 3) intimal thickness index, and 4) intima-to-media ratio. RESULTS: In the adjusted analysis, the systemic arteries of COPD subjects showed greater intimal thickening (%IA) than those of smokers (15.6±1.5% vs. 14.2±1.6%, p = 0.038). In the pulmonary arteries, significant differences were observed for %IA between the 2 groups (37.3±2.2% vs. 29.3±2.3%, p = 0.016). Among clinical factors, metabolic syndrome, gender and COPD status were associated with the systemic intimal thickening, while only COPD status was associated with pulmonary intimal thickening. A correlation between the %IA of the systemic and pulmonary arteries was observed (Spearman's rho = 0.46, p = 0.008). CONCLUSIONS: Greater intimal thickening in systemic and pulmonary arteries is observed in COPD patients than in smokers. There is a correlation between systemic and pulmonary vascular remodelling in the overall population.
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Muñoz‐Esquerre et al. (2016) conducted a cross-sectional in Chronic Obstructive Pulmonary Disease (n=42). COPD vs. Smokers with normal lung function was evaluated on Percentage of intimal area (%IA) of systemic arteries (p=0.038). COPD patients exhibited significantly greater intimal thickening in systemic arteries compared to smokers with normal lung function (15.6% vs. 14.2%, p=0.038).
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