Email this article Aortic stiffness in chronic obstructive pulmonary disease concurrent with coronary heart disease
- Authors: Nevzorova V.A.1, Shekunova O.I.1, Brodskaya T.A.1, Nevzorova VA1, Shekunova OI1, Brodskaya TA1
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Affiliations:
- ГОУ ВПО Владивостокский государственный медицинский университет Росздрава
- Issue: Vol 82, No 3 (2010)
- Pages: 18-22
- Section: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/30544
- ID: 30544
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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.
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.
About the authors
Vera Afanas'evna Nevzorova
ГОУ ВПО Владивостокский государственный медицинский университет Росздрава
Email: nevzorova@inbox.ru
д-р мед. наук, проф., зав. каф. терапии ФПК и ПП с курсами функциональной и клинико-лабораторной диагностики; ГОУ ВПО Владивостокский государственный медицинский университет Росздрава
Ol'ga Ivanovna Shekunova
ГОУ ВПО Владивостокский государственный медицинский университет Росздрава
Email: olga-shekunova@mail.ru
очный аспирант, каф. терапии ФПК и ПП с курсами функциональной и клинико-лабораторной диагностики; ГОУ ВПО Владивостокский государственный медицинский университет Росздрава
Tat'yana Aleksandrovna Brodskaya
ГОУ ВПО Владивостокский государственный медицинский университет Росздрава
Email: brodskaya@mail.ru
канд. мед. наук, зав. аспирантурой и докторантурой, ассистент каф. терапии ФПК и ПП с курсами функциональной и клинико-лабораторной диагностики; ГОУ ВПО Владивостокский государственный медицинский университет Росздрава
V A Nevzorova
O I Shekunova
T A Brodskaya
References
- Чучалин А. Г. Хроническая обструктивная болезнь легких и сопутствующие заболевания. Часть I. ХОБЛ и поражения сердечно-сосудистой системы. Рус. мед. журн. 2008; 16 (2): 58-64.
- Lopez D., Shibuya K., Rao C. et al. Chronic obstructive pulmonale disease: current burden and future projections. Eur. Respir. J. 2006; 27: 397-412.
- Sin D. D., Man S. F. Why are patients with chronic obstructive pulmonary disease at increased risk of cardiovascular diseases? The potential role of systemic inflammation in chronic obstructive pulmonary disease. Circulation 2003; 107: 1514-1519.
- Sin D. D., Wu L., Man S. F. P. The relationship between reduced lung function and cardiovascular mortality: A population-based study and a systematic review of the literature. Chest 2005; 127 (6): 1952-1959.
- Авдеев С. Н. Хроническая обструктивная болезнь легких как системное заболевание. Пульмонология 2007; 2: 104- 113.
- Айсанов 3. Р., Козлова Л. И., Калманова Е. Н., Чучалин А. Г. Хроническая обструктивная болезнь легких и сердечно-сосудистые заболевания: опыт применения формотерола. Пульмонология 2006; 2: 68-70.
- Laurent S., Cockcroft J., Van Bortel L. et al. the European Network for Non-invasive Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur. Heart. J. 2006; 27 (21): 2588-2605.
- Blacher J., Staessen J. A., Girerd X. et al. Pulse pressure not mean pressure determines cardiovascular risk in older hypertensive patients. Arch. Intern. Med. 2000; 160: 1085-1089.
- Гельцер Б. И., Бродская Т. А., Невзорова В. А. Оценка артериальной ригидности у больных хронической обструктивной болезнью легких. Пульмонология 2008; 1: 45-50.
- Олейников В. Э., Матросова И. Б., Томашевская Ю. А., Герасимова А. С. Влияние ингибитора АПФ спираприла на структурно-функциональные свойства сосудистой стенки при метаболическом синдроме и эссенциальной гипертонии. Рос. кардиол. журн. 2006; 58 (2): 36-41.
- Weber T., Auer J., O'Rourke M. F. et al. Prolonged mechanical systole and increased arterial wave reflections in diastolic dysfunction. Heart 2006; 92: 1616-1622.
- Hansen T., Staessen J., Pedersen T. et al. Prognostic value of aortic pulse wave velocity as index of arterial stiffness in general population. Circulation 2006; 113: 664-670.
- Рекомендации Российского медицинского общества по артериальной гипертензии и Всероссийского научного общества кардиологов 2008 г. WWW. CARDIOSITE. RU
- Zieman S. J., Melenovsky V., Kass D. A. Mechanisms, pathophysiology, and therapy of arterial stiffness. Arterioscler. Thromb. Vase. Biol. 2005; 25(5): 932-943.
- Кароли Н. А., Орлова Е. Е., Маркова А. В., Ребров А. П. Коморбидность при хронической обструктивной болезни легких. Тер. арх. 2008; 3: 20-23.
- Моткина Е. В., Невзорова В. А. Функциональное состояние сосудистого эндотелия и хроническое воспаление при ХОБЛ. Тихоокеан. мед. журн. 2005; 2: 34-37.
- Stehouwer C. D. A., Henry R. M. A., Ferreira I. Arterial stiffness in diabetes and the metabolic syndrome: a pathway to cardiovascular disease. Diabetologia 2008; 51: 527-539.
- Arteriograph TensioClinic and its program TensioClinic. User's manual. Early diagnosis of arteriosclerosis, www.medexpert.hu.
- Laurent S., Katsahian S., Fassot C. et al. Aortic stiffness is an independent predictor of fatal stroke in essential hypertension. Stroke 2003; 34 (5): 1203-1206.
- Лопатин Ю. М., Илюхин О. В. Контроль жесткости сосудов. Клиническое значение и способы коррекции. Сердце 2006; 6 (3): 128-132.
- Орлова Я. А., Агеев Ф. Т. Жесткость артерий как интегральный показатель сердечно-сосудистого риска: физиология, методы оценки и медикаментозной коррекции. Сердце 2006; 5 (2): 65-69.
- Anthonisen N. R., Connett J. E., Enright P. L., Manfreda J. Lung Health Study Research Group. Hospitalizations and mortality in the Lung Health Study. Am. J. Respir. Crit. Care. Med. 2002; 166: 333-339.
- Гельцер Б. И., Бродская Т. А., Невзорова В. А. Артериальная ригидность и ХОБЛ: патофизиологические взаимосвязи и клиническое значение. Тер. арх. 2008; 11: 89-95.
- Бродская Т. А., Невзорова В. А., Гельцер Б. И., Моткина Е. В. Эндотелиальная дисфункция и болезни органов дыхания. Тер. арх. 2007; 3: 76-84.
- Кароли Н. А., Ребров А. П. Хроническая обструктивная болезнь легких и кардиоваскулярная патология. Клиницист 2007; 1: 13-19.
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