Abstract
BackgroundCardiovascular disease are common co-morbidities in bronchiectasis and contribute substantially to disease burden and mortality. Brachial-ankle pulse wave velocity (baPWV), a measure of arterial stiffness, has a strong predictive value for cardiovascular event. We hypothesized that baPWV would be increased in steady-state bronchiectasis patients, and correlates with the degree of systemic inflammation and disease severity assessed with Bronchiectasis Severity Index and FACED scores.MethodsEighty patients with steady-state bronchiectasis and 80 age- and sex-matched controls were enrolled. BaPWV was measured as an indicator of arterial stiffness. Demographic, clinical indices, radiology, spirometry, sputum bacteriology and systemic inflammatory mediators were also assessed.ResultsBronchiectasis patients had significantly increased baPWV [median 1514 cm/s vs. 1352 cm/s, P = 0.0003] compared with control subjects. BaPWV significantly correlated with Bronchiectasis Severity Index (rho = 0.65, P < 0.001) and FACED (rho = 0.49, P < 0.001) scores. In multivariate regression analysis, age, Pseudomonas aeruginosa colonization, systolic blood pressure, body-mass index and exacerbation frequency in the last 12 months, but not systemic inflammatory markers, were independent factors influencing on baPWV in bronchiectasis patient after adjustment for other clinical variables. Reproducibility of baPWV measurement was good.ConclusionBronchiectasis patients have increased arterial stiffness compared with control subjects, which correlates with disease severity, but not systemic inflammatory markers. Age, Pseudomonas aeruginosa colonization, systolic blood pressure, body-mass index and exacerbation frequency in last 12 months might independently predict the severity of arterial stiffness in bronchiectasis. Therefore, arterial stiffness might have contributed to the increased risks of developing cardiovascular diseases in bronchiectasis.
Highlights
Cardiovascular disease are common co-morbidities in bronchiectasis and contribute substantially to disease burden and mortality
Our study found that bronchiectasis patients have increased Brachial-ankle pulse wave velocity (baPWV) compared with healthy controls, which was validated in subgroup analysis excluding individuals with concomitant hypertension or coronary heart disease or diabetes
Patients with bronchiectasis had significantly higher baPWV compared with control subjects, mainly determined by age, Pseudomonas aeruginosa (PA) colonization, systolic blood pressure (SBP), body-mass index (BMI) and the number of exacerbation in the last year
Summary
Cardiovascular disease are common co-morbidities in bronchiectasis and contribute substantially to disease burden and mortality. Brachial-ankle pulse wave velocity (baPWV), a measure of arterial stiffness, has a strong predictive value for cardiovascular event. We hypothesized that baPWV would be increased in steady-state bronchiectasis patients, and correlates with the degree of systemic inflammation and disease severity assessed with Bronchiectasis Severity Index and FACED scores. The prevalence of bronchiectasis has been increasing over the past decade and led to substantial morbidity and mortality worldwide [1,2,3]. Recent studies have demonstrated that patients with bronchiectasis have increased risks of developing cardiovascular disease (CVD), and Arterial stiffness reflects the decreased capability of an artery to dilate and contract in response to pressure changes. The carotid-femoral PWV (cfPWV) is the gold standard for assessing arterial stiffness [9, 11], but requires patients’ persistent lateral
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