Published ahead of print on September 20, 2007, doi:10.1164/rccm.200707-1080OC
Am. J. Respir. Crit. Care Med., Volume 176, Number 12, December 2007, 1208-1214
A more recent version of this article appeared on December 15, 2007
Submitted on July 22, 2007
Accepted on September 20, 2007
Arterial Stiffness is Independently Associated with Emphysema Severity in Patients with COPD
David A McAllister1*, John D Maclay1, Nicholas L Mills2, Grant Mair1, Joy Miller1, David Anderson1, David E Newby2, John T Murchison3, and William MacNee1
1 ELEGI/COLT Laboratories, MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom,
2 Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom,
3 Department for Radiology, University of Edinburgh, Edinburgh, United Kingdom
* To whom correspondence should be addressed. E-mail: david.mcallister{at}ed.ac.uk.
Rationale: More patients with COPD die from cardiovascular causes than die from respiratory causes, and patients with COPD have increased morbidity and mortality from stroke and
coronary heart disease. Arterial stiffness independently predicts cardiovascular risk, is associated with atheromatous plaque burden, and is increased in COPD patients compared to controls matched for cardiovascular risk factors. Elastin fragmentation and changes in
collagen are found in the connective tissue of both emphysematous lungs and stiff arteries, but it is not known whether the severity of arterial stiffness in patients with COPD is associated with the severity of emphysema. Objective: To identify whether the extent of arterial stiffness is associated with emphysema severity.
Methods: We measured pulse wave velocity (a validated measure of arterial stiffness), blood pressure, smoking pack years, glucose, cholesterol and C-reactive protein in 157 patients with COPD. We assessed emphysema using quantitative CT scanning in a subgroup of 73 patients.
Results: We found that emphysema severity was associated with arterial stiffness (r = 0.471, p<0.001). The association was independent of smoking, age, sex, FEV1% predicted, highly sensitive C-reactive protein and glucose concentrations, Cholesterol:HDL ratio, and pulse
oximetry oxygen saturations. Further studies are now required to identify the mechanism underlying this newly described association.
Key words: Humans, Elasticity, Cardiovascular Diseases, Pulmonary Emphysema
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