Estimation of arterial stiffness in patients with chronic obstructive pulmonary disease

Abstract

We examined 60 patients with chronic obstructive pulmonary disease (COPD) by noninvasive arteriography (arteriograph TensioClinic TL1 (TensioMed, Hungary) to evaluate a place of arterial stiffness in the pathogenesis of COPD. As a whole, central arterial stiffness in COPD patients is higher than in healthy persons and is expressed in increase in aortic pulse wave velocity (aPWV), augmentation index (IA), and the ratio of coronary perfusion indexes. Increase in the arterial stiffness is stable which could be important for pathogenesis of cardiovascular disturbances in such patients. The arterial stiffness does not progress according to severity of COPD. Aortic stiffness naturally raises in the stages I and II of the disease but it decreases in the stage III. The increase in the aortic stiffness in the early stages is thought to be due to influence of pathogenic factors of the disease; in the stage III, the aortic stiffness decreases because of progressive myocardial hypodynamia. According to findings of noninvasive arteriography, the most informative predictor of cardiovascular risk and COPD severity was the ratio of coronary perfusion indexes. It closely correlated with hypoxemia, and duration and severity of disease. Our results partly explain frequent combination of COPD and cardiovascular pathology. The further researches in this field will be needed to specify pathophysiological mechanisms of vascular dysfunction in COPD.