Subclinical cardiovascular changes in chronic obstructive pulmonary disease patients: Doppler ultrasound evaluation

• Published in: The Egyptian Journal of Bronchology 2015-08, Vol.9 (2), p.140-145
• Main Authors: Sadek, Samiaa H., Hassan, Ali A., AbdElrahman, Ghada, Kasem, Soheir M., AbdElwahed, Lobna, Eldein, Hanan S., Zedan, Mohamed
• Format: Article
• Language: English
• Subjects: Airway management; Atherosclerosis; Blood gas analysis; Chronic obstructive pulmonary disease; Medicine & Public Health; Original Article; Pulmonary arteries; Ultrasonic imaging
• ISSN: 1687-8426; 2314-8551
• DOI: 10.4103/1687-8426.158046

Introduction Chronic obstructive pulmonary disease (COPD) is a disease characterized by progressive poorly reversible airway obstruction. COPD is associated with chronic systemic inflammation, hypercoagulable status, platelet activation, and oxidative stress. These factors may result in subclinical cardiovascular diseases (CVD): for example, carotid atherosclerosis, peripheral arterial diseases, and coronary artery diseases. Aims The aim of this case–control study was the detection of subclinical CVD in COPD patients. Settings and design This was a case–control study. Materials and methods A total of 62 COPD patients and 62 healthy volunteers were enrolled in the present study. All patients were subjected to full medical history and clinical examination, chest radiography, arterial blood gas analysis, laboratory assessment of C-reactive protein, complete blood count, lipid profile, spirometry, transthoracic echocardiography, carotid Doppler ultrasound, and measurement of ankle-brachial index. A comparison between COPD and control groups regarding different parameters was performed, and a comparison between different stages of COPD regarding different parameters was also performed. Results The carotid intima-media thickness and carotid plaques were significantly higher, whereas the ankle-brachial index was significantly lower in COPD patients compared with the control group, with no differences observed in different stages of COPD. Pulmonary hypertension and right ventricular dilatation were significantly common in COPD patients compared with the control group, and they were significantly increased with progressive stages of COPD. Pulmonary artery systolic pressure and carotid intima-media thickness showed a significant negative correlation with PaO 2 , but showed a significant positive correlation with PaCO 2 . Conclusion COPD is a risk factor for subclinical CVD, mainly carotid artery atherosclerosis and peripheral arterial diseases.