Vascular wall rigidity in chronic obstructive pulmonary disease patients


DOI: https://dx.doi.org/10.18565/therapy.2021.8.54-64

Vysotskaya N.V., Li V.V., Zadionchenko V.S., Adasheva T.V., Dolbin S.S., Timofeeva N.Yu.

A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia
Abstract. Nowadays, the interaction between chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) is in no doubt.
The aim of the study was to study the parameters of the daily profile of the vascular wall rigidity and assess the interaction with indicators of the functional state of lungs in patients with COPD of varying severity.
Material and methods. 96 patients with COPD without concomitant cardiovascular diseases (CVD) at the age of 40–75 years were examined. In accordance with the classification of COPD severity (GOLD 1–4), 4 groups of patients were identified. The participants underwent general clinical examination, spirometry, 24-hour pulse oximetry, and 24-hour measurement of vascular wall stiffness.
Results. An increase in the average daily, daytime and nighttime values of aortal pulse wave velocity (PWVao) was revealed with COPD progression: the highest values were observed in the GOLD group 4. The correlation between PWVao and FEV1 (r=-0,454; p <0,001) and SpO2 (r=-0,380; p=0,004) was fixed. The predictive value of FEV1: Wald χ2 = 7,195 (p=0,008) and SpO2: Wald χ2=5,624 (p =0,01). Average daily and nighttime variability indexes of PWVao (var. PWVao) in the GOLD 4 group were significantly higher than in the GOLD 1 group. The correlation relationship of var. PWVao with FEV1 (r=-0,300; p=0,007) and Evd (r=-0,412; p=0,001) was revealed. Prognostic value of Evd: χ2 Wald=7,925 (p=0,006); FEV1: Wald’s χ2=6,895 (p=0,007); SpO2: Wald χ2=4,264 (p=0,02). The study of the circadian rhythm of arterial stiffness (AR) revealed the highest values in the GOLD groups 2 and 4. In the GOLD 2 group, a significant increase in PWVao and its variability during the daytime, augmentation index (Aix), Aix variability (Aix) and arterial stiffness index were revealed (ASI) at night time. In the GOLD 4 group, higher values of PWVao var. were determined during daytime, and Aix and var. Aix at night time.
Conclusion. During the study process it was revealed an increase in vascular wall stiffness and AR circadian rhythm disorder as the severity of COPD progressed. Along with the traditional risk factors for PWVao increase (age, BMI, heart rate, SBP and DBP), the influence of the saturation level and FEV1 was revealed. The correlation between var. PWVao and Evd, FEV1 and SpO2 was determined. The results may indicate a negative effect of COPD functional parameters at AR parameters, which may be one of the reasons for the formation of CVD in patients with COPD.
Keywords: variability of arterial stiffness parameters, daily profile of vascular wall stiffness, vascular wall stiffness, chronic obstructive pulmonary disease
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About the Autors

Nina V. Vysotskaya, senior laboratory assistant of the Department of polyclinic therapy, A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 107150, Moscow, 39/1 Losinoostrovskaya Str. Tel.: +7 (916) 941-88-02. E-mail: nina.smirnova@gmail.com. ORCID: 0000-0002-2991-7854
Vera V. Li, MD, associate professor, professor of the Department of polyclinic therapy, A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 129110, Moscow, 61/2 Shchepkina Str. Tel.: +7 (916) 509-86-63. E-mail: vera0212@yandex.ru. ORCID: 0000-0003-3552-9054
Vladimir S. Zadionchenko, MD, professor, professor of the Department of polyclinic therapy, A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 107150, Moscow, 39/1 Losinoostrovskaya Str. Tel.: +7 (985) 761-74-51. E-mail: z7vladimir@bk.ru. ORCID: 0000-0003-2377-5266
Tatyana V. Adasheva, MD, professor, professor of the Department of polyclinic therapy, A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 107150, Moscow, 39/1 Losinoostrovskaya Str. Tel.: +7 (903) 629-46-07. E-mail: adashtv@mail.ru. ORCID: 0000-0002-3763-8994
Sergei S. Dolbin, postgraduate student of the Department of polyclinic therapy, A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 107150, Moscow, 39/1 Losinoostrovskaya Str. Tel.: +7 (929) 635-17-34. E-mail: sdolbin@yandex.ru. ORCID: 0000-0002-5064-8118
Natalya Yu. Timofeeva, PhD, associate professor, associate professor of the Department of polyclinic therapy, A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 129110, Moscow, 61/2 Shchepkina Str. Tel.: +7 (917) 558-85-83. E-mail: nata.timofeeva@mail.com ORCID: 0000-0002-9315-9533


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