The Role of Total Antioxidant Status in Cerebral Vasoreactivity of Chronic Obstructive Pulmonary Disease Patients

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is associated with an oxidant-antioxidant imbalance. COPD patients have impaired cerebral vasoreactivity (CVR). Impaired CVR could be correlated with total antioxidant status (TAS) in plasma. Aim: To determine the role of systemic TAS in CVR of COPD patients. Material and Methods: In this cross-sectional observational study, we included 120 participants (the mean age of 67±7.9, 87 males), 90 COPD patients categorized according to the severity of airway obstruction in mild, moderate, severe/very severe and 30 age- and sex-matched controls. We analyzed baseline mean flow velocities (MFV) of the middle cerebral artery (MCA) and the basilar artery (BA), the mean breath-holding index (BHIm) of those arteries (BHImMCA and BHImBA) by transcranial Doppler ultrasound and TAS in plasma. The level of significance was set to α=0.05. Results: A significant negative correlation between TAS and BHImBA (Rho=−0.445, P=0.01) was found only in the mild COPD group. In COPD groups, baseline MFV BA is in a significant positive correlation with BHImMCA and BHImBA (Rho=0.336, P=0.001 and Rho=0.647, P<0.001). According to the severity of airway obstruction in COPD groups, a significant positive correlation between baseline MFV BA and BHImBA was found: in mild (Rho=0.731, P<0.001), moderate (Rho=0.574, P=0.001) and severe/very severe (Rho=0.398, P=0.03). Conclusion: Systemic TAS was not correlated with CVR in all COPD groups. However, perfusion in the BA of COPD groups was in a significant positive correlation with the anterior and posterior CVR. The analysis of perfusion in the basal cerebral arteries should be part of a future study of CVR in COPD patients.

Keywords

• chronic obstructive pulmonary disease
• antioxidants
• transcranial doppler ultrasonography
• breath-holding
• cerebral perfusion