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Disconnection of pulmonary and systemic arterial stiffness in COPD.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Weir-McCall, Jonathan R 
Liu-Shiu-Cheong, Patrick Sk 
Struthers, Allan D 
Lipworth, Brian J 
Houston, J Graeme 

Abstract

BACKGROUND: Both pulmonary arterial stiffening and systemic arterial stiffening have been described in COPD. The aim of the current study was to assess pulse wave velocity (PWV) within these two arterial beds to determine whether they are separate or linked processes. MATERIALS AND METHODS: In total, 58 participants with COPD and 21 healthy volunteers (HVs) underwent cardiac magnetic resonance imaging (MRI) and were tested with a panel of relevant biomarkers. Cardiac MRI was used to quantify ventricular mass, volumes, and pulmonary (pulse wave velocity [pPWV] and systemic pulse wave velocity [sPWV]). RESULTS: Those with COPD had higher pPWV (COPD: 2.62 vs HV: 1.78 ms-1, p=0.006), higher right ventricular mass/volume ratio (RVMVR; COPD: 0.29 vs HV: 0.25 g/mL, p=0.012), higher left ventricular mass/volume ratio (LVMVR; COPD: 0.78 vs HV: 0.70 g/mL, p=0.009), and a trend toward a higher sPWV (COPD: 8.7 vs HV: 7.4 ms-1, p=0.06). Multiple biomarkers were elevated: interleukin-6 (COPD: 1.38 vs HV: 0.58 pg/mL, p=0.02), high-sensitivity C-reactive protein (COPD: 6.42 vs HV: 2.49 mg/L, p=0.002), surfactant protein D (COPD: 16.9 vs HV: 9.13 ng/mL, p=0.001), N-terminal pro-brain natriuretic peptide (COPD: 603 vs HV: 198 pg/mL, p=0.001), and high-sensitivity troponin I (COPD: 2.27 vs HV: 0.92 pg/mL, p<0.001). There was a significant relationship between sPWV and LVMVR (p=0.01) but not pPWV (p=0.97) nor between pPWV and RVMVR (p=0.27). CONCLUSION: Pulmonary arterial stiffening and systemic arterial stiffening appear to be disconnected and should therefore be considered independent processes in COPD. Further work is warranted to determine whether both these cause an increased morbidity and mortality and whether both can be targeted by similar pharmacological therapy or whether different strategies are required for each.

Description

Keywords

COPD, arterial compliance, cardiovascular, pulmonary vascular, ventricular function, Adult, Aged, Aged, 80 and over, Case-Control Studies, Forced Expiratory Volume, Germany, Heart, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Organ Size, Pulmonary Disease, Chronic Obstructive, Pulse Wave Analysis, Spirometry, Vascular Stiffness

Journal Title

Int J Chron Obstruct Pulmon Dis

Conference Name

Journal ISSN

1176-9106
1178-2005

Volume Title

13

Publisher

Informa UK Limited