Peripheral arterial disease: an underestimated aetiology of exercise intolerance in chronic obstructive pulmonary disease patients

Castagna, Olivier; Boussuges, Alain; Nussbaum, Eric S.; Marqueste, L.; Brisswalter, Jeanick

doi:10.1097/hjr.0b013e3282f009a9

Cited by 31 publications

(40 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thus, both studies together suggest an association between emphysema and atherosclerotic processes. Previous findings indicated a higher prevalence of PAD in patients with more severe COPD (35,41), which is supported by our univariate analyses. In a multivariate regression model, however, diffusion capacity remained an independent predictor for PAD only, whereas GOLD stages III and IV were no longer significant.…”

Section: Original Articlesupporting

confidence: 79%

“…Previous smaller studies provided conflicting results as to whether or not PAD is associated with 6MWD. Although a rather strong association has been shown by Castagna and colleagues (41) in 151 patients with COPD with GOLD stages II and III, Sun and colleagues (42) did not find a statistical significant difference in 6MWD between patients without PAD and those with PAD. Even after adjusting for several confounders, we found a rather large difference in 6MWD that clearly exceeded the MCID of 30 m compared with those without PAD.…”

Section: Functional Capacitymentioning

confidence: 91%

See 1 more Smart Citation

Peripheral Artery Disease and Its Clinical Relevance in Patients with Chronic Obstructive Pulmonary Disease in the COPD and Systemic Consequences–Comorbidities Network Study

Houben-Wilke

Jörres

Bals

et al. 2017

Am J Respir Crit Care Med

View full text Add to dashboard Cite

Rationale: Knowledge about the prevalence of objectively assessed peripheral artery disease (PAD) and its clinical relevance in patients with chronic obstructive pulmonary disease (COPD) is scarce.Objectives: We aimed to: (1) assess the prevalence of PAD in COPD compared with distinct control groups; and (2) study the association between PAD and functional capacity as well as health status.Methods: The ankle-brachial index was used to diagnose PAD (ankle-brachial index < 0.9). The 6-minute-walk distance, health status (St. George's Respiratory Questionnaire), COPD Assessment Test, and EuroQol-5-Dimensions were assessed in patients enrolled in the German COPD and Systemic Consequences-Comorbidities Network cohort study. Control groups were derived from the Study of Health in Pomerania. Conclusions: In a large cohort of patients with COPD, 8.8% were diagnosed with PAD, which is higher than the prevalence in control subjects without COPD. PAD was associated with a clinically relevant reduction in functional capacity and health status.

show abstract

Section: Original Articlesupporting

confidence: 79%

Section: Functional Capacitymentioning

confidence: 91%

Peripheral Artery Disease and Its Clinical Relevance in Patients with Chronic Obstructive Pulmonary Disease in the COPD and Systemic Consequences–Comorbidities Network Study

Houben-Wilke

Jörres

Bals

et al. 2017

Am J Respir Crit Care Med

View full text Add to dashboard Cite

show abstract

“…34 They stated that there is a considerable effect of peripheral arterial disease on exercise intolerance, and it should be taken into account in COPD treatments, including pulmonary rehabilitation programs.…”

Section: Discussionmentioning

confidence: 99%

Arterial Stiffness Measured Via Carotid Femoral Pulse Wave Velocity Is Associated With Disease Severity in COPD

Çınarka¹,

Kayhan²,

Gümüş³

et al. 2013

Respir Care

View full text Add to dashboard Cite

BACKGROUND: Patients with COPD face an increased risk of cardiovascular disease and increased cardiac mortality. Carotid femoral pulse wave velocity (cf-PWV) is a validated measure of arterial stiffness, a well recognized predictor of adverse cardiovascular outcomes, and offers higher predictive value than classical cardiovascular risk factors. We investigated the association between COPD and arterial stiffness using cf-PWV as a noninvasive technique. METHODS: This clinical study was prospective, observational, and cross-sectional. Sixty-two subjects with stable COPD and 22 healthy controls underwent physical examination, chest x-rays, pulmonary function tests, arterial blood gas analysis, and 6-min walk test, and cf-PWV was measured via a validated tonometry system. RESULTS: The COPD subjects had greater arterial stiffness than the control subjects, and that difference was associated with lower FEV 1 , P aO 2 , and oxygen saturation during the 6-min walk test. We observed higher cf-PWV in the COPD subjects with severe COPD than in the subjects with mild to moderate COPD. Only FEV 1 was an independent predictor of cf-PWV. CONCLUSIONS: Our results suggest that arterial stiffness is increased in subjects with more severe and advanced COPD than in those with mild to moderate COPD. Air flow limitation and hypoxemia may induce increased arterial stiffness in COPD patients.

show abstract

“…Further, arterial stiffness (assessed by PWV) is also associated with shorter walking distance during a 6-minute walk test in patients with chronic obstructive lung disease. 38 An association between arterial stiffness and exercise performance has also been noted in patients with PAD. In 106 patients (82 with PAD, mean age 69 years, mean ABI 0.87) who were referred for non-invasive lower extremity arterial evaluation, measures of arterial stiffness (augmentation index, pulse pressure and reflected wave arrival time) were independently associated with shorter walking distance.…”

Section: Arterial Stiffnessmentioning

confidence: 99%

Arterial dysfunction and functional performance in patients with peripheral artery disease: A review

2011

View full text Add to dashboard Cite

Functional performance influences quality of life in individuals with peripheral artery disease (PAD) and is also a powerful prognostic marker in these patients. The pathophysiology of impaired functional performance in patients with PAD is incompletely understood. The severity of atherosclerotic burden, non-invasively assessed by the ankle-brachial index (ABI), does not reliably predict the degree of functional impairment observed in PAD patients. We review associations of measures of arterial function (arterial stiffness and endothelial dysfunction) with functional performance in PAD patients, and also review potential therapies for arterial stiffness and endothelial dysfunction that could improve functional performance in PAD. Recent studies suggest that measures of arterial function, such as arterial stiffness and endothelial function, are associated with exercise performance in the setting of PAD. These studies have provided new insights into (1) the pathophysiology of functional impairment in PAD, (2) mechanisms of strategies known to be effective such as walking programs, and (3) potential new therapeutic interventions for improving functional performance. Thus, therapies aimed at arterial 'de-stiffening' and improving endothelial function (such as aerobic exercise, statins and angiotensinconverting enzyme inhibitors) may improve functional performance in patients with PAD; however, further investigations are needed.

show abstract

Peripheral arterial disease: an underestimated aetiology of exercise intolerance in chronic obstructive pulmonary disease patients

Cited by 31 publications

References 16 publications

Peripheral Artery Disease and Its Clinical Relevance in Patients with Chronic Obstructive Pulmonary Disease in the COPD and Systemic Consequences–Comorbidities Network Study

Peripheral Artery Disease and Its Clinical Relevance in Patients with Chronic Obstructive Pulmonary Disease in the COPD and Systemic Consequences–Comorbidities Network Study

Arterial Stiffness Measured Via Carotid Femoral Pulse Wave Velocity Is Associated With Disease Severity in COPD

Arterial dysfunction and functional performance in patients with peripheral artery disease: A review

Contact Info

Product

Resources

About