Systemic vascular dysfunction is associated with emphysema burden in mild COPD

Zelt, Jason G.E.; Jones, Joshua H.; Hirai, Daniel M.; King, Trevor J.; Berton, Danilo Cortozi; Pyke, Kyra E.; O’Donnell, Denis E.; Neder, J. Alberto

doi:10.1016/j.rmed.2018.01.007

Cited by 13 publications

(11 citation statements)

References 59 publications

(77 reference statements)

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“…Arterial stiffness is a strong predictor of cardiovascular disease [47,48], and emphysema severity based on quantitative computed tomography scans in turn was revealed as the most powerful predictor of arterial stiffness [49]. Moreover, systemic vascular dysfunction seems to already be present in the earlier stages of COPD, and particularly in patients with emphysema, although presenting with a largely preserved FEV1 [50].…”

Section: Coronary Artery Disease In Copdmentioning

confidence: 99%

The Role of Omega-3 Fatty Acids in the Setting of Coronary Artery Disease and COPD: A Review

et al. 2018

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Chronic obstructive pulmonary disease (COPD) is a growing healthcare concern and will represent the third leading cause of death worldwide within the next decade. COPD is the result of a complex interaction between environmental factors, especially cigarette smoking, air pollution, and genetic preconditions, which result in persistent inflammation of the airways. There is growing evidence that the chronic inflammatory state, measurable by increased levels of circulating cytokines, chemokines, and acute phase proteins, may not be confined to the lungs. Cardiovascular disease (CVD) and especially coronary artery disease (CAD) are common comorbidities of COPD, and low-grade systemic inflammation plays a decisive role in its pathogenesis. Omega-3 polyunsaturated fatty acids (n-3 PUFAs) exert multiple functions in humans and are crucially involved in limiting and resolving inflammatory processes. n-3 PUFAs have been intensively studied for their ability to improve morbidity and mortality in patients with CVD and CAD. This review aims to summarize the current knowledge on the effects of n-3 PUFA on inflammation and its impact on CAD in COPD from a clinical perspective.

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Section: Coronary Artery Disease In Copdmentioning

confidence: 99%

The Role of Omega-3 Fatty Acids in the Setting of Coronary Artery Disease and COPD: A Review

et al. 2018

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“…Hence, 21 studies enrolling 638 patients with COPD and 595 controls were included in this systematic review. From the 21 studies, only 19 studies (with 968 participants) [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] were included in the quantitative analysis, since available data for the rest 2 were inadequate [42,43].…”

Section: Search Resultsmentioning

confidence: 99%

“…Of the 21 studies included in this systematic review, 16 studies evaluating endothelial function only via FMD (8 NMD) [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43], 2 only via VOP [forearm blood flow (FBF) assessment after bradykinin infusion] [23,24], 1 study via FMD and VOP (FBF after a typical post-occlusion reactive hyperemia protocol) [25], 1 study via PAT [26] and 1 study via FMSF [27]. Seven studies included patients with COPD, without overt cardiovascular disease [23, 26, 31-33, 39, 40] and 1 study included patients with COPD and CAD co-existence [25].…”

Section: Study Characteristicsmentioning

confidence: 99%

Endothelial dysfunction in COPD: a systematic review and meta-analysis of studies using different functional assessment methods

et al. 2021

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BackgroundCardiovascular disease is a major cause of morbidity and mortality in chronic obstructive pulmonary disease (COPD). Endothelial dysfunction is suggested to be one of the pathogenetic mechanisms involved. This is a systematic review and meta-analysis of studies using any available functional method to examine differences in endothelial function between patients with COPD and individuals without COPD (controls).MethodsLiterature search involved PubMed and Scopus databases. Eligible studies included adult patients and evaluated endothelial damage via functional methods. Newcastle-Ottawa Scale was applied to evaluate the quality of retrieved studies. Subgroup analyses were performed to explore heterogeneity across the studies. Funnel-plots were constructed to evaluate publication bias.ResultsOf the 21 initially identified reports, 19 studies with a total of 968 participants were included in the final meta-analysis. A significantly impaired response in endothelium-dependent (weighted mean between-group difference, WMD: −2.59%, 95%CI [−3.75, −1.42]) and –independent vasodilation (WMD: −3.13, 95%CI [−5.18, −1.09]) was observed in patients with COPD compared to controls. When pooling all studies together, regardless of the technique used for assessment of vascular reactivity, pronounced endothelial dysfunction was observed in COPD compared to controls (standardised-mean-difference, SMD: −1.19, 95%CI [−1.69, −0.68]). Subgroup analysis showed that the difference was larger when patients with COPD were compared with non-smoking controls (SMD: −1.75, 95%CI [−2.58, −0.92]. Sensitivity analyses confirmed the above results.ConclusionsPatients with COPD have significantly impaired endothelial function compared to controls without COPD. Future studies should delineate the importance of endothelial dysfunction towards development of cardiovascular disease in COPD.

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“…However, Katz et al reported that in an invasive femoral venous blood study, patients with heart failure had higher oxygen extraction in leg muscles at peak exercise than healthy subjects [51]. Similarly, Zelt et al reported that in patients with mild COPD, there was higher oxygen extraction in forearm muscles performing a continuous isometric handgrip squeeze at 20% of maximal voluntary contraction for 1.5 min compared to age-matched normal subjects [11]. We speculate that (1) the femoral vein and NIRS provide different information, as the former collects both superficial and deep leg veins whereas the latter collects the superficial microcirculation, and (2) all of the previous studies and the present study used different exercise protocols and different methods to calculate HbO 2 , HHb, and TOT, and measured different groups of muscles, and that all of these factors may have caused the difference in the results.…”

Section: Discussionmentioning

confidence: 99%

“…Even though the mechanisms of myopathy, muscle morphology, muscle fiber type distribution and shifting, and muscle metabolism in the locomotor muscles are similar in patients with COPD and CHF [1,9], exercise-induced hypoxemia, if it occurs, is expected to aggravate hypoxic stress in patients with COPD, as the patterns of muscle cytochrome oxidase gene activation are altered in these patients [8]. In addition, hypoxemia may cause an increase in myostatin protein expression, which is related to muscle atrophy [10], and patients with COPD can experience vascular dysfunction with a higher extraction of muscle oxygen during exercise even in the early stage [11]. Therefore, it is not clear whether there are differences in the functions of locomotor and ventilatory muscles between patients with COPD and CHF who have similar daily exercise performance and dyspnea sensation.…”

Section: Introductionmentioning

confidence: 99%

More Impaired Dynamic Ventilatory Muscle Oxygenation in Congestive Heart Failure than in Chronic Obstructive Pulmonary Disease

Chuang

Lin²,

Hsieh

2019

JCM

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Patients with chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) often have dyspnea. Despite differences in primary organ derangement and similarities in secondary skeletal muscle changes, both patient groups have prominent functional impairment. With similar daily exercise performance in patients with CHF and COPD, we hypothesized that patients with CHF would have worse ventilatory muscle oxygenation than patients with COPD. This study aimed to compare differences in tissue oxygenation and blood capacity between ventilatory muscles and leg muscles and between the two patient groups. Demographic data, lung function, and maximal cardiopulmonary exercise tests were performed in 134 subjects without acute illnesses. Muscle oxygenation and blood capacity were measured using frequency-domain near-infrared spectroscopy (fd-NIRS). We enrolled normal subjects and patients with COPD and CHF. The two patient groups were matched by oxygen-cost diagram scores, New York Heart Association functional classification scores, and modified Medical Research Council scores. COPD was defined as forced expired volume in one second and forced expired vital capacity ratio ≤0.7. CHF was defined as stable heart failure with an ejection fraction ≤49%. The healthy subjects were defined as those with no obvious history of chronic disease. Age, body mass index, cigarette consumption, lung function, and exercise capacity were different across the three groups. Muscle oxygenation and blood capacity were adjusted accordingly. Leg muscles had higher deoxygenation (HHb) and oxygenation (HbO2) and lower oxygen saturation (SmO2) than ventilatory muscles in all participants. The SmO2 of leg muscles was lower than that of ventilatory muscles because SmO2 was calculated as HbO2/(HHb+HbO2), and the HHb of leg muscles was relatively higher than the HbO2 of leg muscles. The healthy subjects had higher SmO2, the patients with COPD had higher HHb, and the patients with CHF had lower HbO2 in both muscle groups throughout the tests. The patients with CHF had lower SmO2 of ventilatory muscles than the patients with COPD at peak exercise (p < 0.01). We conclud that fd-NIRS can be used to discriminate tissue oxygenation of different musculatures and disease entities. More studies on interventions on ventilatory muscle oxygenation in patients with CHF and COPD are warranted.

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Systemic vascular dysfunction is associated with emphysema burden in mild COPD

Cited by 13 publications

References 59 publications

The Role of Omega-3 Fatty Acids in the Setting of Coronary Artery Disease and COPD: A Review

The Role of Omega-3 Fatty Acids in the Setting of Coronary Artery Disease and COPD: A Review

Endothelial dysfunction in COPD: a systematic review and meta-analysis of studies using different functional assessment methods

More Impaired Dynamic Ventilatory Muscle Oxygenation in Congestive Heart Failure than in Chronic Obstructive Pulmonary Disease

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