Significant Increase of Arterial Stiffness in Patients With COPD Linked With Severity of Emphysema, Dyslipidemia

Although arterial stiffness in patients with chronic obstructive pulmonary disease (COPD) increases over time, a greater annual increase may be associated with the severity of emphysema, systemic inflammation, and dyslipidemia, according to study findings published in the International Journal of Chronic Obstructive Pulmonary Disease.

Researchers examined arterial stiffness in patients with COPD by utilizing an annual augmentation index (AIx) through applanation tonometry for a maximum of 7 years. The study authors also performed annual assessments of lung function, blood gases, systemic inflammation, serum lipids, and blood pressure.

“Arterial stiffness assessed by pulse wave velocity (PWV) and augmentation index (AIx) is a strong predictor of cardiovascular events and all-cause mortality in the general population. Several cross-sectional studies have shown increased arterial stiffness in COPD patients when compared to healthy controls,” said the study authors. “Recently, a longitudinal study of cardiovascular risk in COPD patients (ARCADE-Study) confirmed increasing PWV in COPD patients over a period of 2 years. Various mechanisms in the development of arterial stiffness in COPD have been proposed.”

In total, 76 patients were included in the study cohort. Of these patients, the AIx demonstrated a significant annual increase of 0.91% adjusted for baseline. Additionally, the change in diffusion capacity (DLco), low-density lipoprotein, and high-sensitivity C-reactive protein were independently associated with the increasing evolution of AIx. The average age at baseline was 62.4 years old, with 67% being male and 21% classified as current smokers.

“We found an annual increase of AIx indicating progressive rigidity of the arterial wall in COPD patients over time. Decreasing DLco, a surrogate marker of emphysema, as well as increasing systemic inflammation and dyslipidaemia enhanced the increasing evolution of arterial stiffness over time,” said the study authors. “Our results add novel information to the field of cardiovascular risk in patients with COPD. By assessing potential predictors on the course of arterial stiffness, these data provide additional information useful for predicting the cardiovascular disease course of COPD patients in clinical practice.”

Researchers concluded that further studies are necessary to better understand the interactions of CO diffusion capacity, serum lipids, and inflammation in patients with COPD and to better understand their clinical implications.

Reference

Roeder M, Sievi NA, Kohlbrenner D, et al. Arterial stiffness increases over time in relation to lung diffusion capacity: A longitudinal observation study in COPD [published online January 23, 2020]. Int J of Chron Obstruct Pulmon Dis. doi: 10.2147/COPD.S234882.