The role of endothelial dysfunction and oxidative stress in the formation of cardiovascular comorbidity in patients with chronic obstructive pulmonary disease


DOI: https://dx.doi.org/10.18565/therapy.2019.5.62-68

Mayorova M.V., Grigorieva N.Yu., Samolyuk M.O.

1) The City clinical hospital No. 5, Nizhny Novgorod 2) Privolzhsky research medical University of the Ministry of Healthcare of Russia, Nizhny Novgorod
The purpose of the study was to evaluate oxidative stress and endothelial dysfunction in patients with chronic obstructive pulmonary disease (COPD) who have concomitant cardiovascular pathology.
Material and methods. A total of 389 patients were examined at the cardiology de-partment of the City Clinical Hospital No. 5 in Nizhny Novgorod. All patients were divided into three groups. Group 1 is represented by comorbid patients who have COPD in combination with ischemic heart disease (IHD). Group 2 included patients with only IHD without COPD, in group 3 - patients with COPD whithout symptoms of any cardiovascular disease, including IHD.
Results. The maximum changes in all parameters of lipid peroxidation (LPO) were revealed in patients with comorbid pathology of COPD and IHD, besides the excessive production of free radicals with formation of a large amount of final products of LPO, their delayed elimination was revealed. In patients of group 1 (COPD and IHD), the increase in the diameter of the brachial artery after its decompression was on average 3,42 ±1,32%, which is significantly lower than in groups 2 and 3. The amount of NO2 and NO3 in patients of Groups 1 and 2 was significantly lower than normal, but did not differ significantly between each other. In Group 3 patients, the content of nitric oxide metabolites exceeded the normal values and was significantly higher than in Groups 1 and 2 (p <0,001 and p <0,001 respectively). In comorbid patients of group 1, the total amount of nitric oxide was formed from the significantly reduced of its normal range «vasodilating» NO synthesized by endothelial NO synthase and the nitric oxide produced by macrophage NO-synthase, compared with the norm.
Conclusion. The generality of pathophysiological manifestations of oxidative stress in COPD and cardiovascular pathology can underlie their combined development, as well as determine mutual influence. Increasing cardiovascular comorbidity in patients with COPD results in the rising of pathological reactions, which lead to the development of pronounced oxidative stress and aggravation of endothelial dysfunction, and therefore will contribute to the diseases progression.
Keywords: endothelial dysfunction oxidative stress, сomorbidity, chronic obstructive pulmonary disease, arterial hypertension, coronary artery disease
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About the Autors

Maria V. Mayorova, cardiologist-arrhythmologist of the City clinical hospital No. 5. Address: 603005, Nizhny Novgorod, 34 Nesterova Str. Tel.: +7 (831) 438-98-19.
Natalia Yu. Grigorieva, MD, professor of the Department of faculty and polyclinic therapy of Privolzhsky research medical University of the Ministry of Healthcare of Russia, scientific consultant of the City clinical hospital No. 5. Address: 603005, Nizhny Novgorod, 10/1 Minin Sq. Tel.: +7 (831) 438-98-19; +7 (905) 667-40-96. E-mail: grigoreva28@mail.ru
Marina O. Samolyuk, PhD candidate of the Department of faculty and polyclinic therapy of Privolzhsky research medical University of the Ministry of Healthcare of Russia. Address: 603005, Nizhny Novgorod, 10/1 Minin Sq. Tel.: +7 (831) 438-98-19.


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