An acute exacerbation of COPD requiring hospitalization was associated with impaired vascular function that significantly improved by 0.215 RHI units (p=0.031) within 14 days of discharge.
Cohort (n=144)
No
Does an acute exacerbation of COPD requiring hospitalization impair vascular function, arterial stiffness, and systemic inflammation compared to stable COPD?
Severe AECOPD requiring hospitalization is associated with acute systemic inflammation and impaired vascular function that persists for at least 14 days post-discharge, providing a mechanistic link for elevated cardiovascular risk in this population.
p-value: p=0.031
An acute exacerbation of COPD (AECOPD) is associated with increased risk of cardiovascular (CV) events. The elevated risk during an AECOPD may be related to changes in vascular function, arterial stiffness, and systemic inflammation; the time course of these measures and their corresponding recovery are poorly understood. Further, physical activity is reduced during an AECOPD, and physical activity may influence the cardiovascular responses to an AECOPD. The purpose of the study was to examine the acute impact of an AECOPD requiring hospitalization on vascular function, arterial stiffness, and systemic inflammation and examine whether physical activity modulates these variables during recovery. Patients hospitalized for an AECOPD were prospectively recruited and compared to control patients with stable COPD. Vascular function, arterial stiffness, and systemic inflammation (CRP, IL-6) were measured at hospital admission, hospital discharge and within 14 days of discharge. Physical activity was electronically tracked daily while in hospital and for 7 days following discharge using a Fitbit. One hundred and twenty-one patients with an AECOPD requiring hospitalization and 33 control patients with stable COPD were enrolled in the study. Vascular function was significantly lower, and systemic inflammation higher at hospital admission in patients with an AECOPD compared to stable COPD. Significant improvements in vascular function and inflammation were observed within 14 days of hospital discharge; however, vascular function remained lower than stable COPD. Physical activity was low at admission and increased following discharge; however, physical activity was unrelated to measures of vascular function or inflammation at any time point. An AECOPD requiring hospitalization is associated with impaired vascular function that persists during recovery. These findings provide a mechanistic link to help explain the enduring increase in CV risk and mortality following a severe AECOPD event.Clinical trial registration: ClinicalTrials.gov #NCT01949727; Registered: 09/20/2013.
Fuhr et al. (Fri,) conducted a cohort in Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (n=144). Hospitalization for AECOPD vs. Stable COPD was evaluated on Change in Reactive Hyperemia Index (RHI) from admission to 14-day follow-up (p=0.031). An acute exacerbation of COPD requiring hospitalization was associated with impaired vascular function that significantly improved by 0.215 RHI units (p=0.031) within 14 days of discharge.