title: Systemic and Pulmonary Vascular Remodelling in Chronic Obstructive Pulmonary Disease.
abstract: BACKGROUND
  Chronic Obstructive Pulmonary Disease (COPD) is associated with subclinical systemic atherosclerosis and pulmonary vascular remodelling characterized by intimal hyperplasia and luminal narrowing. We aimed to determine differences in the intimal thickening of systemic and pulmonary arteries in COPD subjects and smokers. Secondary aims include comparisons with a non-smokers group; determining the clinical variables associated with systemic and pulmonary intimal thickening, and the correlations between systemic and pulmonary remodelling changes.
  
  
  METHODS
  All consecutive subjects undergoing lung resection were included and divided into 3 groups: 1) COPD, 2) smokers, and 3) non-smokers. Sections of the 5th intercostal artery and muscular pulmonary arteries were measured by histo-morphometry. Four parameters of intimal thickening were evaluated: 1) percentage of intimal area (%IA), 2) percentage of luminal narrowing, 3) intimal thickness index, and 4) intima-to-media ratio.
  
  
  RESULTS
  In the adjusted analysis, the systemic arteries of COPD subjects showed greater intimal thickening (%IA) than those of smokers (15.6±1.5% vs. 14.2±1.6%, p = 0.038). In the pulmonary arteries, significant differences were observed for %IA between the 2 groups (37.3±2.2% vs. 29.3±2.3%, p = 0.016). Among clinical factors, metabolic syndrome, gender and COPD status were associated with the systemic intimal thickening, while only COPD status was associated with pulmonary intimal thickening. A correlation between the %IA of the systemic and pulmonary arteries was observed (Spearman's rho = 0.46, p = 0.008).
  
  
  CONCLUSIONS
  Greater intimal thickening in systemic and pulmonary arteries is observed in COPD patients than in smokers. There is a correlation between systemic and pulmonary vascular remodelling in the overall population.
authors.affiliation: Department of Pulmonary Medicine, Bellvitge University Hospital -IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Mariana
authors.initials: M
authors.lastname: Muñoz-Esquerre
authors.affiliation: Department of Pulmonary Medicine, Bellvitge University Hospital -IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: López-Sánchez
authors.affiliation: Department of Thoracic Surgery, Bellvitge University Hospital -IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Escobar
authors.affiliation: Department of Pulmonary Medicine, Bellvitge University Hospital -IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Huertas
authors.affiliation: Department of Pathology, Bellvitge University Hospital -IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Penín
authors.affiliation: Department of Pulmonary Medicine, Bellvitge University Hospital -IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.|Biomedical Research Networking Center Consortium -Respiratory Diseases (CIBERES), Barcelona, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Molina-Molina
authors.affiliation: Department of Pulmonary Medicine, Bellvitge University Hospital -IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Frederic
authors.initials: F
authors.lastname: Manresa
authors.affiliation: Department of Pulmonary Medicine, Bellvitge University Hospital -IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Dorca
authors.affiliation: Department of Pulmonary Medicine, Bellvitge University Hospital -IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.|Biomedical Research Networking Center Consortium -Respiratory Diseases (CIBERES), Barcelona, Spain.
authors.forename: Salud
authors.initials: S
authors.lastname: Santos
mesh_terms: D000368:Aged; D001011:Aorta / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000473:pathology; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000473:pathology*; D012307:Risk Factors; D012720:Severity of Illness Index; D017539:Tunica Intima / Q000473:pathology; D061205:Vascular Calcification / Q000473:pathology; D066253:Vascular Remodeling