Artery Research (Nov 2016)

7.9 CAROTID ARTERY STIFFNESS IS ASSOCIATED WITH CT-MEASURED LUNG AIR-TRAPPING IN COPD PATIENTS AND CONTROLS INDEPENDENT OF AGE, BLOOD PRESSURE AND SMOKING HISTORY

  • Gary Pierce,
  • John Newell,
  • Alejandro Comellas,
  • Eric Hoffman,
  • Kelsey Warner,
  • Anna Croghan,
  • Lyndsey DuBose,
  • Peg Nopoulos,
  • Vince Magnotta,
  • Stephan Arndt,
  • Karin Hoth

DOI
https://doi.org/10.1016/j.artres.2016.10.055
Journal volume & issue
Vol. 16

Abstract

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Background: Early stages of chronic obstructive pulmonary disease (COPD) are characterized by loss of the terminal bronchioles and ‘air trapping’ often before overt emphysema manifests (1). COPD patients are also at risk for cardiovascular disease (CVD), therefore, we hypothesized that the degree of air trapping on computed tomography (CT) (2) would be associated with higher aortic (carotid femoral pulse wave velocity, CFPWV) and carotid artery stiffness (β-stiffness), biomarkers of CVD risk. Methods: Ten adults with COPD but little emphysema (age 66±8 yrs, 5F/5M, GOLD stage 1–3) and 9 adults without COPD (age 59±13 yrs, 5F/4M) that had a research chest CT were recruited. Results: COPD patients had greater smoking history (45.9 ± 21 vs. 6.4 ± 12.9 pack-years, P<0.001) and air trapping (0.85± 0.07 vs. 0.78 ±0.05 Expiration/Inspiration attenuation ratio, p<0.05) (2) compared with non-COPD subjects, but did not differ by age, BMI, SaO2%, brachial BP or % emphysema (all p>0.05). COPD patients had significantly higher CFPWV (999± 293 vs. 760 ±147 cm/sec, p<0.05) but not carotid β-stiffness (13.3± 5.1 vs. 10.6 ±4.7 U, p=0.26). In the entire cohort (n=19), air trapping was associated with higher CFPWV (r=0.60, p<0.01) and carotid β-stiffness (r=0.75, p<0.001). After adjustment for age, mean BP and pack-years, the correlation between carotid β-stiffness and air-trapping remained significant (r=0.68, p<0.01). Conclusions: Carotid artery stiffness is significantly associated with air trapping in COPD patients and controls, independent of age, smoking history and BP. This suggests a link between high CVD risk in COPD patients with small airway disease without predominant emphysema.