Increased brachial intima-media thickness is associated with circulating levels of asymmetric dimethylarginine in patients with COPD

Abstract

BackgroundChronic obstructive pulmonary disease (COPD) is associated with an increased cardiovascular risk. However, the mechanisms for this association are yet unclear. The aim of this study was to investigate the relationship between brachial intima-media thickness (B-IMT), an independent predictor of cardiovascular risk, systemic inflammation, and asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, in patients with COPD and respective controls.MethodsThe study sample consisted of 60 patients with stable COPD, free from overt cardiovascular disorders, as well as 20 smoking and 20 nonsmoking controls. Ultrasound assessment of B-IMT, spirometry, venous blood sampling for quantification of inflammatory markers and ADMA levels were carried out, and individual cardiovascular risk was calculated via the Framingham risk score.ResultsPatients with COPD showed significantly higher B-IMT compared to smoking (P=0.007) and nonsmoking controls (P=0.033). COPD patients with elevated B-IMT had a twofold increased calculated 10-year risk for cardiovascular events compared to those below the recommended cutoff (P=0.002). B-IMT was significantly associated with systemic inflammation (interleukin-6 [IL-6]; r=0.365, P=0.006) and ADMA (r=0.331, P=0.013) in COPD. Multivariate linear regression revealed male sex and ADMA as independent predictors of B-IMT in this study sample.ConclusionB-IMT is significantly increased in patients with COPD and is associated with systemic inflammation and ADMA levels.

ADMA and NT pro‐BNP are associated with overall mortality in elderly

“…Concentrations of L-arginin, which are influenced by protein intake, were lower in the elderly patients under study compared with our previous observation in other group of patients. [9][10][11][12][13][14][15][16][17][18] The statistical correlation between increased ADMA plasma concentration and mortality in older patients is in agreement with the Framingham heart study and a previous Haemoglobin (g/dL) b 11.9 ± 1.5 12.9 ± 1.7…”

“…Mean plasma concentrations of ADMA and SDMA were higher than those of patients with diabetes, COPD or cardiovascular disease using the same analytical method. Concentrations of L‐arginin, which are influenced by protein intake, were lower in the elderly patients under study compared with our previous observation in other group of patients …”

Systemic vascular dysfunction is associated with emphysema burden in mild COPD

“…3). Lack of concomitant measurements of pro-inflammatory status and oxidative stress can also be viewed as a relevant limitation [12]. However, large variability of these measurements in previous cross-sectional investigations suggest that our study would be underpowered to adequately address this topic.…”

“…Interestingly, several lines of evidence have recently uncovered a hitherto unknown link between emphysema extension and cardiovascular disease beginning during the earlier stages of COPD, i.e., patients with preserved FEV 1 (Global Initiative for Chronic Obstructive Lung Disease (GOLD) spirometric grade 1) [9][10][11]. The prevailing view is that repeated COPD exacerbations are associated with chronic pro-inflammatory [12] and hyper-oxidative stresses [13] which can impair systemic vascular function [14][15][16], as indicated by higher aortic stiffness [17] and impaired flow-mediated vasodilatation [18]. Due to either ensuing cardiovascular co-morbidities [19] or a chronic sedentary life style [20], these patients present with higher effort-related dyspnea (GOLD 2017 clinical group B) [16].…”

Intima-media thickness of the common femoral arteries as a marker for coronary atherosclerosis in patients with coronary artery disease

“…Также следует отметить потенциальную ключевую роль хронического воспаления. Известно, что у пациентов с различными хроническими системными воспалительными заболеваниями отмечается увеличение ТКИМ сонных артерий [28,29]. В исследовании PESA (Progression of Early Subclinical Atherosclerosis) оценивали воспаление в сосудистой стенке различных артериальных бассейнов методом гибридной визуализации (магнитно-резонансная томография, совмещенная с позитронно-эмиссионной томографией с 18 F-фтордезоксиглюкозой) [30].…”