Aortic stiffness in chronic obstructive pulmonary disease concurrent with coronary heart disease


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Abstract

Aim. To study aortic stiffness in patients with chronic obstructive pulmonary disease (COPD) concurrent with coronary heart disease (CHD).
Subjects and methods. Twenty-eight patients with CHD-associated COPD, 27 patients with isolated COPD in remission (a comparison group), and 30 gender- and age-matched healthy volunteers (a control group) were examined. Aortic stiffness was assessed by noninvasive arteriography, by determining the aortic pulse wave velocity (APWV), augmentation index (AI), systolic and diastolic coronary cycle index area ratio, and left ventricular (LV) ejection fraction index.
Results. Noninvasive arteriography showed that in COPD concurrent with CHD, aortic stiffness was much higher (there were increases in APWV, AI, and relative coronary perfusion indices) than in COPD only. At the same time, no significant differences were found in the coronary perfusion in COPD only and in that concurrent with CHD. In CHD-associated COPD, there was an inverse correlation between decreased SaO2 and increased APWV and a direct association between the lower values of external respiration function and the level of hypoxemia, the poorer conditions of coronary perfusion, and diminished LV myocardial contractility.
Conclusion. In COPD concurrent with CHD, central arterial stiffness is drastically increased as compared to that in healthy individuals and patients with COPD alone. There are no differences in the values of coronary perfusion in isolated COPD and its association with CHD, suggesting that COPD is of its own value in the formation of a cardiovascular risk. The correlation between the major parameters of aortic stiffness and the level of hypoxemia, on the one hand, and decreased lung ventilation function, on the other, testify their great contribution to the increase in the stiffness of elastic-type vessel walls in CHD-associated COPD.

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