Resistin, 8-isorpostanes and stress right ventricular diastolic dysfunction - predictors for exacerbations in non-severe chronic obstructive pulmonary disease patients

Abstract

<b>Background:</b> Oxidative stress and systemic inflammation have been assumed as pathophysiological triggers in chronic obstructive pulmonary disease (COPD) progression. <b>Aims and objectives:</b> To determine the association between resistin, 8-isoprostanes, stress right ventricular diastolic dysfunction (RVDD) and exacerbations. <b>Methods:</b> 104 patients with non-severe COPD (FEV1&gt;50%) underwent incremental cardio-pulmonary exercise testing (CPET). Echocardiography was performed before and 1-2 minutes after exercise. ELISA was applied for resistin; 8-isoprostanes were determined by high resolution accurate mass spectrometry. Patients were followed on the 6th and 12th month. Correlation and ROC analysiswereperformed. <b>Results:</b> 82 patients were with RVDD and 22 without. In RVDD 8-isoprostanes and resistin were higher. Resistin correlated with stress RVE/e’, exacerbations during the first 6 and not during 6-12 months. Isoprostanes did not correlate to RVE/e’ but with exacerbations – in first 6 and 6-12 months. Resistin &gt; 8.23 (Se 76,5% and Sp 66,3) and 8-isoprostane &gt;23.71 (Se 82,4%;Sp – 56,0%) may predict outcome during the first 6 months; 8-isoprostane &gt;32,55 - during the 6-12month (Se 60,00%;Sp – 76,8%). Right atrium volume index (RAVI), right ventricle (RV) wall thickness, RV E/a at rest and stress RVE/e’ showed association with exacerbation rate at 6th and 6th- 12th month but with moderate predictive value. <b>Conclusion:</b> Resistin plasma levels and urinary 8-isoprostane concentration correlated to exacerbation rates and may be of clinical usefulness in addition to stress-echocardiography