Vascular endothelial dysfunction in chronic obstructive pulmonary disease: Comparison with bronchial asthma, and controls

Abstract

Background: The association between vascular endothelial dysfunction and chronic obstructive pulmonary disease (COPD) has so far remained unclear. Objective: To clarify the degree of endothelial dysfunction in COPD, compared with bronchial asthma (BA) and controls with normal lung function. Methods: In total, 41 COPD, 35 BA patients and 20 age-matched controls were enrolled in this study. Endothelial dysfunction was evaluated with flow-mediated dilatation (FMD). FMD is defined as percentage change in the brachial artery diameter with reactive hyperemia. We examined FMD in COPD, BA patients, and controls. To exclude the burden of airflow limitation on endothelial dysfunction, FMD was compared between COPD and BA subjects with airflow limitation, and multiple regression analysis was performed. Data were presented with mean and 95% confidence interval (CI). Results: Age and body mass index (BMI) of COPD, BA patients, and controls were matched. %FEV 1 of COPD, BA, and controls were 70.4% (61.2 – 79.7), 96.9% (88.7 – 105.1), and 110.3% (102.6 – 118.1).Mean FMD was 3.15% (2.57-3.75%) in COPD, which is significantly lower than BA: 4.92% (4.13 – 5.71%), p = 0.0007 and controls: 5.54% (4.39 – 6.69%), p = 0.0002. In comparison between COPD and BA with airflow limitation: age and %FEV 1 was matched. Mean FMD was 3.17% (2.52 – 3.82%) in COPD, which is also lower significantly than BA: 4.88% (3.40 – 6.37%), p = 0.02. The diagnosis of COPD was identified by multiple regression analysis as a significant factor associated with decreased FMD% (Estimated coeficient= -1.45, 95% CI = -2.30 to -0.61; p = 0.01). Conclusions: COPD was associated with vascular endothelial dysfunction.