Relationship between aortic pulse wave velocity and mid cerebral artery pulsatility index in patients with chronic obstructive pulmonary disease; pilot data from the ARCADE Study

Abstract

BackgroundChronic obstructive pulmonary disease (COPD) is an inflammatory condition associated with increased cardiovascular risk. COPD patients have increased aortic stiffness and increased risk of stroke. In addition, increased mid cerebral artery pulsatility index (MCAPI) is associated with increased arterial stiffness and risk of stroke in patients with Diabetes. However, the mechanisms relating to the increased risk of stroke in COPD remain unclear. Therefore, this study aims to investigate the relationship between aortic pulse wave velocity (aPWV) and the MCAPI in COPD patients.MethodsThis Cross-sectional evaluation included 20 COPD patients (mean ±SD, age 69.0 ±6.3 years) from the ACRADE study. aPWV was measured using the SphygmoCor system and MCAPI using transcranial Doppler ultrasound. In addition, forced expiratory volume in the first second/ forced vital capacity (FEV1/FVC) was measured using spirometry and quality of life was assessed using the St George’s Respiratory Questionnaire (SGRQ). Measures of frailty were assessed using Time-Up-and-Go test (TUG) and the Comprehensive Geriatric Assessment (CGA).ResultsMCAPI was significantly associated with aPWV (r = 0.518, P = 0.033). aPWV was significantly associated with SGRQ disease impact (r = 0.604, P = 0.010) and also associated with TUG (r=0.561, P=0.019) and CGA (r = 0.639, P = 0.006).ConclusionsThese pilot data highlight the association between increased aortic stiffness and increased pulsatile flow velocity transmitted to the cerebral circulation of COPD patients. In addition, COPD symptoms, impact and frailty are both associated with increased aortic stiffness. However, more research is needed to investigate cause and effect between COPD symptoms, impact and its relationship between aPWV and cerebral flow pulsatility.