Endothelial damage and functional state of the vascular wall in chronic obstructive pulmonary disease.

Abstract

Chronic obstructive pulmonary disease (COPD) creates conditions for endothelial damage with the development of endothelial dysfunction: hypoxia, an increase in biologically active substances, including cytokines, leukotrienes, etc. Previous studies have been conducted in COPD patients with a combination of arterial hypertension and coronary heart disease. The aim of the study was to evaluate the endothelial damage and the vasoregulatory function of the vascular wall in patients with COPD of varying severity. Material and methods. The study included 76patients with COPD (men, mean age 51.14 ± 0.97years). COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease (2013) guidelines. The patients were divided into two groups according to COPD severity: the 1st group (GOLD I-II) included 27 patients, the 2nd group (GOLD III-IV) included 49 patients. Antithrombogenic, vasoregulatory function of the endothelium, synthesis of nitric oxide (NO) in blood plasma by the level of stable NO metabolites (nitrates and nitrites) was studied. The number of desquamated endotheliocytes, von Willebrand factors in the blood was determined. As a result of the study, a significant damage to the endothelium, an increase in the thickness of the wall of the brachial artery, a decrease in the total plasma concentration of stable NO metabolites, a violation of the antithrombogenic and vasoregulatory activity of the vascular wall in COPD patients compared with healthy people. The most significant changes were found in patients with severe COPD.