Adverse effect of smoking on cross‐sectional area of small pulmonary vessel and arterial stiffness in healthy smokers without COPD

Abstract

Introduction Because it induces systemic inflammation, smoking is a risk factor of atherosclerosis and pulmonary hypertension. The brachial‐ankle pulse wave velocity (baPWV) and cross‐sectional area (CSA) of small pulmonary vessels can be useful markers to assess early changes of arterial stiffness and pulmonary vascular alteration in smokers. Objectives This study aimed to explore association between the CSA of small pulmonary vessel and arterial stiffness in healthy male smokers. Methods We enrolled 90 male non‐smokers and 90 male smokers (age: 51.5 ± 9.7 years and 52.1 ± 7.9 years, respectively). All subjects underwent chest computed tomography (CT), pulmonary function test and baPWV measurement. We evaluated the total CSAs less than 5 mm2 using ImageJ software and divided by the total lung area (%CSA<5). We compared the association between baPWV and %CSA<5 in two groups as well as correlations among the amount of smoking, baPWV and %CSA<5. Multiple linear regression analysis using %CSA<5 as the dependent variable was also performed. Results The mean baPWV and mean %CSA<5 were significantly different between the smokers and non‐smokers. The pack‐years was significantly correlated with %CSA<5 (r = −0.631, P < 0.001) and baPWV (r = 0.534, P < 0.001) in smokers. In multiple linear regression analysis, age, pack‐years, FEV1/FVC and baPWV were associated with %CSA<5, regardless of body mass index, blood pressure and heart rate. Conclusions There is a dose‐response relationship between cigarette smoking and the CSA of small pulmonary vessels and arterial stiffness, respectively. Arterial stiffness, age, pack‐years and mild airflow impairment are independent predictors of small pulmonary vascular destruction in smokers.

Avaliação da Rigidez Arterial Central em Idosos não Hipertensos: Estudo Longitudinal

“…The present study has some limitations, such as the lack of evaluation on tobacco use as a factor of increased arterial stiffness, as previously described [27,28]. However, our data showed that the percentage of smokers was similar between the groups examined.…”

“…Atualmente, tem-se conhecimento de ampla gama de fatores que influenciam o estado das artérias e, como consequência, a VOP (12)(13)(14)27,28).…”

“…Já é bem demonstrada a influência de polimorfismos genéticos dos sistemas endotelina, aldosterona sintetase, dos receptores tipo I da angiotensina II e da angiotensina II, entre outros, sobre a VOP. A deficiência de apolipoproteína-E, a ativação plaquetária, a proteína C-reativa de alta sensibilidade, os níveis plasmáticos e os índices de resistência à insulina, a excreção urinária de albumina, os peptídeos natriuréticos, a adiponectina, a adrenomedulina, todos esses vêm mostrando relações ( 29)com a VOP (13,27,30).…”

The utility of quantitative computed tomography in cohort studies of chronic obstructive pulmonary disease: a narrative review

“…Moreover, the same research team demonstrated the feasibility of this method in determining whether patients with COPD should undergo right heart catheterization. Besides, Jo et al ( 67 ) suggested that %CSA measurement and pulmonary small vessel changes have the theoretical potential for useful diagnostic applications aimed at early-stage assessment of COPD with pulmonary hypertension. In addition, COPD patients with emphysema and functional small-airway disorders may have a correlation between the total pulmonary vascular volume (TPVV), as measured by CT, and exercise-induced dyspnea symptoms.…”