Journal of the Bahrain Medical Society
Year 2020, Volume 32, Issue 1, Pages 3-8
https://doi.org/10.26715/jbms.32_2020_1_2Adarshkumar Bellad1, Rajiv Raina2, Sanjeev Asotra3, Malay Sarkar4, Ashok Sharma2, Jayaprakash S Appajigol1*
1Department of General Medicine, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
2Professor, Department of General Medicine, Indira Gandhi Medical College, Shimla, India
3Assistant Professor, Department of Cardiology, Indira Gandhi Medical College, Shimla, India
4Professor, Department of Pulmonary Medicine, Indira Gandhi Medical College, Shimla, India
*Corresponding author:
Jayaprakash S Appajigol, Associate Professor, Department of General Medicine, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India; Tel. No.: (+91) 9844595659; Email: jayaprakashappajigol@hotmail.com
Received date: June 23, 2019; Accepted date: December 12, 2019; Published date: March 31, 2020
Abstract
Background: Chronic Obstructive Pulmonary Disease (COPD) has systemic consequences, including cardiovascular disease. The endothelial functions are impaired in COPD patients, correlating with the severity of the disease. Our study is designed to examine the endothelial function in COPD patients by studying Flow Mediated Dilatation (FMD) and its correlation to severity of disease.
Methods: Patients more than 35 years of age with stable COPD were included in the study. Focused examination was carried out to record blood pressure, ankle brachial index and signs of heart failure. Detailed biochemical investigations were done along with ECG, Chest X-ray, Spirometry, FMD, and carotid intima media thickness in all patients. Age- and sex-matched healthy subjects without any evidence of systemic disease were recruited as controls.
Results: Fifty-nine consecutive COPD patients along with their age- and sex-matched controls were evaluated. Of the 118 patients, 06 (10.2%) in control group had carotid plaque, while 26 (44.1%) patients in the COPD group were observed to have carotid plaque (p<0.0001). Mean FMD in the control group was 13.765±4.428 and among COPD patients was 5.7440±3.2698 (p<0.0001).
Conclusions: Endothelial dysfunction measured by FMD was independently associated with Forced Expiratory Volume in the first second (FEV1) i.e., severity of COPD. We also found that there was higher likelihood of subclinical atherosclerosis and peripheral vascular disease to be present in COPD patients. Hence, cardiovascular risk factors should be evaluated in all COPD patients.
Keywords: Endothelial Function; Flow Mediated Dilatation; Atherosclerosis; COPD; FEV1