Journal article
CT-measured lung air-trapping is associated with higher carotid artery stiffness in individuals with chronic obstructive pulmonary disease
Journal of applied physiology (1985), Vol.125(6), pp.1760-1766
12/01/2018
DOI: 10.1152/japplphysiol.00580.2018
PMCID: PMC6859127
PMID: 30307820
Abstract
Early stages of chronic obstructive pulmonary disease (COPD) are characterized by the loss and narrowing of terminal bronchioles in the lung, resulting in “air-trapping,” often occurring before overt emphysema manifests. Individuals with an airway-predominant phenotype of COPD display extensive lung air-trapping and are at greater cardiovascular disease (CVD) risk than COPD patients with an emphysema-predominant phenotype. We hypothesized that the degree of computed tomography (CT)-quantified lung air-trapping would be associated with greater aortic and carotid artery stiffness and lower endothelial function, known biomarkers of CVD risk. Lung air-trapping was associated with greater aortic stiffness (carotid femoral pulse wave velocity, CFPWV) (
r
= 0.60,
P
= 0.007) and carotid β-stiffness (
r
= 0.75,
P
= 0.0001) among adults with (
n
= 10) and without (
n
= 9) a clinical diagnosis of COPD and remained significant after adjusting for blood pressure (BP) and smoking history (pack-years) (carotid β-stiffness:
r
= 0.68,
P
< 0.01; CFPWV
r
= 0.53,
P
= 0.03). The association between lung air-trapping and carotid β-stiffness remained significant after additionally adjusting for age and forced expiratory volume 1(FEV
1
) (
r
= 0.64,
P
= 0.01). In the COPD group only (
n
= 10), lung air-trapping remained associated with carotid β-stiffness (
r
= 0.82,
P
= 0.05) after adjustment for age, pack-years, and FEV
1
. In contrast, no association was observed between CFPWV and lung air-trapping after adjustment for BP, pack-years, age, and FEV
1
(
r
= 0.12,
P
= 0.83). Lung air-trapping was not associated with endothelial function (brachial artery flow-mediated dilation) in the entire cohort (
P
= 0.80) or in patients with COPD only (
P
= 0.71). These data suggest that carotid artery stiffness may be a mechanism explaining the link between airway-predominant phenotypes of COPD and high CVD risk.
NEW & NOTEWORTHY
Previous cross-sectional studies have demonstrated greater large elastic artery stiffness and lower endothelium-dependent dilation in chronic obstructive pulmonary disease (COPD) patients compared with controls. Furthermore, COPD patients with emphysema have greater aortic stiffness than non-COPD controls, and the degree of stiffness is associated with emphysema severity. The present study is the first to demonstrate that even before overt emphysema manifests, lung air-trapping is associated with carotid artery stiffness in COPD patients independent of blood pressure, age, or smoking history.
Details
- Title: Subtitle
- CT-measured lung air-trapping is associated with higher carotid artery stiffness in individuals with chronic obstructive pulmonary disease
- Creators
- Rachel E Luehrs - University of IowaJohn D Newell - University of IowaAlejandro P Comellas - University of IowaEric A Hoffman - University of IowaKelsey Warner - University of IowaAnna Croghan - University of IowaLyndsey E DuBose - University of IowaPeggy Nopoulos - University of IowaVincent Magnotta - University of IowaStephan Arndt - University of IowaGary L Pierce - University of IowaKarin F Hoth - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of applied physiology (1985), Vol.125(6), pp.1760-1766
- DOI
- 10.1152/japplphysiol.00580.2018
- PMID
- 30307820
- PMCID
- PMC6859127
- NLM abbreviation
- J Appl Physiol (1985)
- ISSN
- 8750-7587
- eISSN
- 1522-1601
- Publisher
- American Physiological Society; Bethesda, MD
- Grant note
- U01 HL089897; U01 HL089856 / ; K23 HL095658; R01 HL08989; R21 AG043722; U54TR001356 / ; ; P30 ES05605 / ; 13SDG143400012 / ; ;
- Alternative title
- AIR-TRAPPING AND ARTERIAL STIFFNESS IN COPD
- Language
- English
- Date published
- 12/01/2018
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Radiology; Psychiatry; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Biostatistics; Nursing; Injury Prevention Research Center; Health, Sport, and Human Physiology ; Internal Medicine
- Record Identifier
- 9984002337302771
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