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Flow-mediated dilation of the brachial artery and endothelial dysfunction in different COPD phenotypes

Background: Endothelial function, as measured by flow mediated dilation (FMD), is impaired in COPD patients, correlating with the severity of bronchial obstruction. Recent studies have shown deterioration of endothelial function during acute exacerbation of COPD. However, information on endothelial dysfunction in different COPD phenotypes is lacking. Aim: The aim of this study was to explore whether there are differences in endothelial function and pulmonary function tests between the two phenotypically distinct groups of COPD patients according to frequency of acute exacerbation. Methods: 117 patients were enroled. COPD patients were divided into two groups according to the criteria of frequency of acute exacerbation: 41 frequent exacerbator and 41 infrequent exacerbator. The control group included 35 healthy smokers. The lung function was measured in all three groups. Endothelial function was assessed by brachial artery flow-mediated dilatation (FMD) and endothelium-independent, nitroglycerin-induced dilation (NMD). Results: The frequent exacerbator group had worse mean FMD (4.6% vrs 6.9% vrs 12.1%, p<0.001) and lower mean FEV1 (38.6% vrs 51.8% vrs 98.5%, p<0.001) compared with the infrequent exacerbator and control group. The infrequent exacerbator group had worse mean FMD and FEV1 compared with control group of healthy smokers (p<0, 001). Conclusion: Between the two phenotypic groups of COPD patients, there is a difference in the degree of endothelial dysfunction.

COPD - exacerbations, Circulation, Lung function testing

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