Abstract
Background: Although several large cohort studies have already shown an association between chronic airflow limitation and subclinical carotid atherosclerosis, the underlying mechanisms for this relationship are still unclear.
Aim: To investigate the possible connections between the carotid intima-media thickness (cIMT) as an atherosclerosis hallmark, and the pulmonary and extrapulmonary effects of COPD.
Methods: In a cross-sectional study, 109 patients with stable COPD underwent spirometry together with determination of maximal respiratory pressure (MIP and MEP), blood sampling, chest radiogram, carotid ultrasonography, six-minute walk test (6MWT), dynamometry, and bioelectrical impedance analysis for body composition.
Results: In all stages of COPD the mean values of cIMT were greater than 0.92 mm, the optimal predictive cutoff value for the presence of atheromatous plaques, according to our ROC curve analysis. Even though we have found significant differences in cIMT values related to the severity of COPD (1.03±0.14 in GOLD 2, vs. 1.07±0.17 in GOLD 3, and vs. 0.95±0.18 in GOLD 4; p=0.04), we did not find a direct correlation with FEV1 (r=0.02, p=0.84) and post-hoc analysis showed a more significant carotid wall thickness in early stages (p<0.05). We also have found a significant correlation between cIMT with the muscular dysfunction profile (MIP: r=-0.28, p<0.01; hand grip force: r=-0.31, p<0.01; 6MWT distance: r=-0.28, p<0.01), and with the body composition parameters (fat body weight r=0.32, p=0.001).
Conclusions: The atherosclerotic changes are present from the early stages of COPD, being in a closer relationship with the muscular dysfunction, rather than with the airflow obstruction.
- © 2014 ERS
