02.03 Aortic Stiffness and Wave Reflections are Increased in Patients with Chronic Obstructive Pulmonary Disease (COPD)

Abstract

Background

Patients with COPD are at greater cardiovascular risk, even after allowing for confounding risk factors such as smoking. Arterial stiffness is an independent predictor of cardiovascular events. We have therefore assessed arterial stiffness in patients with COPD.

Methods

Patients with COPD (n = 75), 42 male were studied when clinically stable, together with 42 age and gender matched healthy smokers (HS). The degree of airways obstruction was assessed using spirometry. Circulating IL-6 and TNFα soluble receptors (sr) I&II in all subjects and arterialised capillary pO2 in patients were measured. Augmentation index (AIx) and Aortic pulse wave velocity (APWV) were determined as measures of wave reflections and aortic stiffness respectively using the Sphygmocor system.

Results

Patients, median (range) age 66 (45–86) years exhibited airways obstruction across a wide spectrum of severity. Mean arterial pressure (MAP) was similar in patients and HS, while AIx, APWV, peripheral pulse pressure, and circulating inflammatory mediators were all higher in patients than HS (see table). In patients, APWV was related to age (r = 0.63, p < 0.0001), IL-6 (r = 0.31, p < 0.01), TNFα srI (r = 0.27, p < 0.05), airways obstruction (r = 0.43, p < 0.01) and inversely related to pO₂ (r = –0.34, p < 0.01).

Table 1

Conclusions

Aortic stiffness and wave reflections are increased in patients with COPD. Aortic stiffness is related to the severity of airways obstruction, systemic inflammation and hypoxia. This may explain the increased risk of cardiovascular disease in this population.