Published ahead of print on August 29, 2007, doi:10.1164/rccm.200707-980OC
Am. J. Respir. Crit. Care Med., Volume 176, Number 12, December 2007, 1200-1207
A more recent version of this article appeared on December 15, 2007
Submitted on July 3, 2007
Accepted on August 29, 2007
Impaired Flow-mediated Dilation is Associated with Low Pulmonary Function and Emphysema in Ex-smokers
R Graham Barr1*, Sonia Mesia-Vela2, John HM Austin3, Robert C Basner2, Brad M Keller4, Anthony P Reeves5, Daichi Shimbo2, and Lori Stevenson2
1 Department of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA,
2 Department of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA,
3 Department of Radiology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA,
4 Department of Biomedical Engineering, College of Engineering, Cornell University, Ithaca, NY, USA,
5 School of Electrical and Computer Engineering, College of Engineering, Cornell University, Ithaca, NY, USA
* To whom correspondence should be addressed. E-mail: rgb9{at}columbia.edu.
Rationale: Basic science research suggests a causal role for endothelial dysfunction in COPD. Clinical studies examining endothelial function are lacking, particularly early in the disease. Flow-mediated dilatation (FMD) is a physiologic measure of endothelial reactivity to endogenous nitric oxide.
Objectives: We hypothesized that lower FMD among former smokers would be associated with lower post-bronchodilator FEV1, higher CT percent emphysema and lower diffusing capacity.
Methods: We measured FMD, pulmonary function and CT percent emphysema in a random sample of 107 cotinine-confirmed former smokers in the ongoing EMCAP Study. FMD was defined as percent change in the brachial artery diameter with reactive hyperemia. Generalized
additive models were used to adjust for potential confounders and assess linearity.
Measurements and Main Results: Mean age of participants was 71±5 years, 46% were female,and packyears averaged 48±26. Mean FMD was 3.8±3.1%; mean post-bronchodilator FEV1, 2.3±0.8 L; and mean CT percent emphysema, 26±10%. A one SD decrease in FMD was associated with a 132 mL (95% CI: 16, 248; P=0.03) decrement in post-bronchodilator FEV1 and a 2.6% (95% CI 0.5, 4.7; P=0.02) increase in CT percent emphysema in fully adjusted models. These associations were linear across the spectrum from normality to disease, independent of smoking history, and also significant among participants without COPD. Associations with diffusing capacity were consistent but non-significant (P=0.09). The FMD-FEV1 association was entirely attributable to percent emphysema.
Conclusions: Impaired endothelial function, as measured by FMD, was associated with lower FEV1 and higher CT percent emphysema in former smokers early in COPD.
Key words: pulmonary disease, chronic obstructive; bronchitis, chronic; pulmonary emphysema; endothelial dysfunction
This article has been cited by other articles:
|
|
|
|
 
O. C. Burghuber and A. Valipour
Knowing Chronic Obstructive Pulmonary Disease by Heart: Cumulating Evidence of Systemic Vascular Dysfunction
Am. J. Respir. Crit. Care Med.,
September 15, 2009;
180(6):
487 - 488.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. D. Maclay, D. A. McAllister, N. L. Mills, F. P. Paterson, C. A. Ludlam, E. M. Drost, D. E. Newby, and W. MacNee
Vascular Dysfunction in Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med.,
September 15, 2009;
180(6):
513 - 520.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. W. Sims, D. J. Margolis, A. R. Localio, R. A. Panettieri, S. M. Kawut, and J. D. Christie
Impact of Pulmonary Artery Pressure on Exercise Function in Severe COPD
Chest,
August 1, 2009;
136(2):
412 - 419.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. J. Barnes and B. R. Celli
Systemic manifestations and comorbidities of COPD
Eur. Respir. J.,
May 1, 2009;
33(5):
1165 - 1185.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Eickhoff, A. Valipour, D. Kiss, M. Schreder, L. Cekici, K. Geyer, R. Kohansal, and O. C. Burghuber
Determinants of Systemic Vascular Function in Patients with Stable Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med.,
December 15, 2008;
178(12):
1211 - 1218.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. MacNee, J. Maclay, and D. McAllister
Cardiovascular Injury and Repair in Chronic Obstructive Pulmonary Disease
Proceedings of the ATS,
December 1, 2008;
5(8):
824 - 833.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Luppi, F. Franco, B. Beghe, and L. M. Fabbri
Treatment of Chronic Obstructive Pulmonary Disease and Its Comorbidities
Proceedings of the ATS,
December 1, 2008;
5(8):
848 - 856.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. MacNee
Update in Chronic Obstructive Pulmonary Disease 2007
Am. J. Respir. Crit. Care Med.,
April 15, 2008;
177(8):
820 - 829.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Sabit and D. J. Shale
Vascular Structure and Function in Chronic Obstructive Pulmonary Disease: A Chicken and Egg Issue?
Am. J. Respir. Crit. Care Med.,
December 15, 2007;
176(12):
1175 - 1176.
[Full Text]
[PDF]
|
|
|
Copyright © 2007 American Thoracic Society
|
|
|
