06.05 Aortic Stiffness and Left Ventricular Diastolic Dysfunction in Patients with Chronic Obstructive Pulmonary Disease (COPD)

Abstract

Background

Patients with COPD have increased aortic stiffness which may contribute to the excess cardiovascular risk in this group. Increased aortic stiffness increases left ventricular (LV) afterload and may contribute to impaired LV relaxation and diastolic dysfunction. We investigated LV diastolic function and its relationship to aortic stiffness in patients with COPD.

Methods

36 COPD patients (19 male) and 14 age and gender matched healthy smokers (HS), both groups free of cardiovascular disease, were studied at clinical stability. The degree of airways obstruction was assessed using spirometry. Measures of LV diastolic function – mitral E/A, isovolu-metric relaxation time (IVRT) and E/Ea were determined using echocardiography with myocardial velocity imaging. Aortic pulse wave velocity (APWV) was determined as a measure aortic stiffness using the Sphygmocor system.

Results

Patients, mean (SD) age 66.5(8.9) years exhibited airways obstruction across a wide spectrum of severity. Patients had a longer mean (SD) IVRT, 125(15.2) ms, compared with HS, 98.2(21.1) ms, p<0.01. E/Ea was also greater in patients than controls (p<0.01), while mitral E/A was similar between groups. APWV was higher in patients (11.5(2.9) m/s) than HS (9.45(1.3) m/s), p<0.001. In patients APWV was related to E/E_A (r = 0.55, p<0.01), mitral E/A (r = -0.38, p<0.05) and IVRT (r = -0.46, p<0.01). APWV was the only significant predictor of IVRT in a mf aortic PWV may be useful in the assessment of LV diastolic dysfunction.y with myocardial velocity imaging. VIVionultiple regression analysis that included age and mean arterial pressure (r sq = 0.22).

Conclusions

COPD patients have LV diastolic dysfunction which is related to aortic stiffness. Aortic PWV may be a useful marker of LV diastolic function in patients with COPD.