Reduced six-minute walking distance, high fat-free-mass index and hypercapnia are associated with endothelial dysfunction in COPD

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• 作者：Cl¨¦mence Minet ; Isabelle Vivodtzev ; Renaud Tamisier ; Fran?ois Arbib ; Bernard Wuyam ; Jean-Fran?ois Timsit ; Denis Monneret ; Jean-Christian Borel ; Jean-Philippe Baguet ; Patrick L¨¦vy ; Jean-Louis P¨¦pin
• 关键词：COPD ; Endothelial function ; Six-minute walking distance ; Systemic inflammation ; Fat-free-mass
• 刊名：Respiratory Physiology & Neurobiology
• 出版年：2012
• 出版时间：15 August, 2012
• 年：2012
• 卷：183
• 期：2
• 页码：128-134
• 全文大小：487 K

文摘

This study investigated the determinants of endothelial function in patients with chronic obstructive pulmonary disease (COPD). Digital pulse amplitude augmentation was measured by post-ischemic reactive hyperemia (RH-PAT) in 44 COPD patients and analyzed with covariates: condition vs. exacerbation, fat-free mass index (FFMI), pulmonary function, blood pressure, inflammation, six-minute walking distance, muscle function, medications, diabetes and prevalent cardiovascular diseases. RH-PAT was 0.43 (?0.14 to 1.30) with 50 % of patients exhibiting abnormal RH-PAT ¡Ü 0.40. After adjustment for age and sex, RH-PAT was linked to condition, FFMI, myocardial infarction history, FEV₁, PaCO₂, heart rate, bicarbonates, inflammation and walking distance (p < 0.10). In multivariate analysis, walking distance, FFMI and PaCO₂ were independent contributors of RH-PAT explaining 49 % of the variance (p < 0.0001). Higher FFMI was associated with higher inflammation, oxidative stress and endothelial dysfunction. Six-minute walking distance which is a widely available marker of severity and functional capacity in COPD patients is a main predictor of endothelial dysfunction.