Carotid arterial stiffness in patients with chronic obstructive pulmonary disease

Background: Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality. Patients with COPD have a cardiovascular risk three times greater than the normal population and cardiac disease accounts for about 50% of deaths in these patients. Arterial stiffness is a marker of increased cardiovascular risk and a predictor for cardiovascular morbidity and mortality. There is evidence of increased aortic stiffness in COPD. The aim of our study is to determine parameters of carotid arterial stiffness in patients with stable COPD. Patients and methods: We enrolled 38 patients with COPD and 36 matched controls. All subjects were evaluated by clinical history and spirometry; parameters of carotid stiffness (beta stiffness index - beta stiffness index, arterial compliance - AC, pulse wave velocity - PWV, augmentation index - AIx) were determined using an ultrasound device (ALOKA ProSound alpha 10). Results: Patients with COPD have increased markers of arterial stiffness compared to controls (beta stiffness index, p=0.03; AC, p=0.002; carotid PWV, p<0.001; AIx, p<0.001). There were no differences between the two groups regarding the classical cardiovascular risk factors with the exception of smoking history. Patients with severe pulmonary disease had more increased beta stiffness index and PWV than those with mild and moderate disease (p=0.03, respectively p=0.004). Conclusions: Patients with COPD had increased carotid arterial stiffness. In severe forms of COPD, arterial stiffness seems to be more important than in mild and moderate pulmonary disease.