title: Determinants of endothelial function in patients with COPD.
abstract: Chronic obstructive pulmonary disease (COPD) is associated with increased cardiovascular mortality. Endothelial dysfunction may underpin this association. This cross-sectional study aimed to determine the impact of airflow obstruction, systemic inflammation, oxidative stress, sympathetic activation, hypoxaemia and physical activity on endothelial function in COPD. In stable COPD patients, assessments of endothelial function by flow-mediated dilatation (FMD), cardiovascular risk (Pocock score), airflow obstruction (forced expiratory volume in 1 s (FEV1)), systemic inflammation (high-sensitivity C-reactive protein and interleukin-6), oxidative stress (malondialdehyde), sympathetic activation (baroreflex sensitivity), hypoxaemia (arterial oxygen tension), hypercapnia (arterial carbon dioxide tension (PaCO2)), physical activity (steps per day) and exercise capacity (6-min walking distance) were performed. Associations between FMD and potential determinants were assessed in univariate and multivariate analyses. 106 patients (Global Initiative for Chronic Obstructive Lung Disease stage I/II 35%, stage III 25% and stage IV 40%) were included. In multivariate analysis FEV1 was positively associated with FMD, independent of other significant FMD determinants from univariate analysis (sex, smoking, combined inhaled long-acting β-adrenergic and steroid medication, heart rate, baroreflex sensitivity and PaCO2) and adjusted for potential confounders (cardiovascular risk and age). In addition, the FMD and FEV1 association was modified by physical activity. The findings of this study demonstrate that the severity of airflow obstruction is a significant determinant of endothelial function in patients with COPD. A high level of physical activity seems to have a favourable effect on this association.
authors: University Hospital Zurich, Zurich.
authors: Christian F
authors: CF
authors: Clarenbach
authors: Oliver
authors: O
authors: Senn
authors: Noriane A
authors: NA
authors: Sievi
authors: Giovanni
authors: G
authors: Camen
authors: Arnoldus J R
authors: AJ
authors: van Gestel
authors: Valentina A
authors: VA
authors: Rossi
authors: Milo A
authors: MA
authors: Puhan
authors: Robert
authors: R
authors: Thurnheer
authors: Erich W
authors: EW
authors: Russi
authors: Malcolm
authors: M
authors: Kohler
mesh_terms: D000305:Adrenal Cortex Hormones / Q000737:chemistry; D000328:Adult; D000368:Aged; D017704:Baroreflex; D001784:Blood Gas Analysis; D001794:Blood Pressure; D001916:Brachial Artery / Q000473:pathology; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000150:complications / Q000503:physiopathology*; D015331:Cohort Studies; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005541:Forced Expiratory Volume; D006339:Heart Rate; D006801:Humans; D000860:Hypoxia; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D010100:Oxygen / Q000737:chemistry; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology*; D012044:Regression Analysis; D012306:Risk; D013564:Sympathetic Nervous System / Q000503:physiopathology
chemical_list: D000305:Adrenal Cortex Hormones; D002097:C-Reactive Protein; D010100:Oxygen