Systemic comorbidities in bronchiectasis

Abstract

Bronchiectasis is a chronic inflammatory lung disease, which has similarities to chronic obstructive pulmonary disease (COPD). Comorbidities of COPD include increased risk of cardiovascular (CV) disease, loss of bone mineral density (BMD) and loss of skeletal muscle mass and function, all linked to systemic inflammation. The potential for such comorbidities has not been explored in bronchiectasis. We hypothesised that patients with bronchiectasis would have similar increased comorbidities. A total of 20 patients with noncystic fibrosis bronchiectasis were compared to 20 controls similar in age, gender and smoking exposure. Assessments included aortic pulse wave velocity (PWV; (a measure of arterial stiffness and an independent predictor of CV risk), blood pressure (BP) as well as levels of interleukin-6 (IL-6), albumin, fasting glucose and lipids. Body composition (fat free mass index (FFMI)), BMD, the 6-min walk distance (6MWD) and self-reported physical activity were also determined. Patients with bronchiectasis had increased aortic PWV, 10.5 (3.0) m/second, when compared with controls, 8.8 (1.6) m/second (p < 0.05), despite similar central and peripheral BP and lipid profile. Patients also had increased IL-6 and reduced albumin and glucose. Although mean body mass index, FFMI and BMD were similar in patients and controls, only 20% of patients had a healthy BMD compared with 50% of controls. Patients had reduced 6MWD and reported less physical activity (p < 0.05). Patients with bronchiectasis had increased arterial stiffness (an indicator of increased CV risk), increased inflammation, reduced exercise capacity and bone thinning. These additional comorbidities require further evaluation for their management in these patients.

High‐intensity inspiratory muscle training in bronchiectasis: A randomized controlled trial

“…We also found no change in PFT and dyspnoea after H‐IMT in patients with bronchiectasis, similar to the previous studies using IMT . The smoking history was minimal which is similar to the previous findings in patients with bronchiectasis . The findings may reveal that H‐IMT does not affect expiratory airflow and breathlessness in mild lung function impairment.…”

“…5,8 The smoking history was minimal which is similar to the previous findings in patients with bronchiectasis. 25 The findings may reveal that H-IMT does not affect expiratory airflow and breathlessness in mild lung function impairment. Chronic fatigue is frequent in bronchiectasis and may affect exercise capacity and QOL.…”

Rehabilitation in Patients with Chronic Respiratory Disease Other than Chronic Obstructive Pulmonary Disease: Exercise and Physical Activity Interventions in Cystic Fibrosis and Non-Cystic Fibrosis Bronchiectasis

“…Troosters et al [13] reported that 75% of adult patients with stable CF (mean FEV 1 65% of the predicted value) have a 6-min walking distance below the limits of normal, while up to 90% of these patients showed a decreased peak aerobic capacity. A decreased 6-min walking distance has also been reported in non-CF bronchiectasis [15]. …”

“…Moderate-intensity activities are typically considered necessary to maintain physical fitness [48]. In non-CF bronchiectasis, objective outcomes of physical activity are not available, but self-reported physical activity is also decreased [15]. …”

Validity and Reliability of the Chronic Respiratory Disease Questionnaire in Elderly Individuals with Mild to Moderate Non-Cystic Fibrosis Bronchiectasis

“…This may be associated with inflammation and progressive tissue destruction with abnormal lung function [2,3,4,5]. Clinically, it is characterised by chronic and commonly purulent sputum expectoration, fatigue, reduced exercise capacity and progressive dyspnoea that can become disabling [2,3,4,5,6,7,8]. People with non-CF bronchiectasis frequently experience recurrent acute exacerbations due to a vicious cycle of persistent infection and inflammation [9,10].…”