Autonomic and cerebrovascular abnormalities in mild COPD are worsened by chronic smoking

L. Bernardi, G. Casucci, T. Haider, E. Brandstätter, E. Pocecco, I. Ehrenbourg, M. Burtscher

Research output: Contribution to journalArticle

Abstract

Patients with chronic obstructive pulmonary disease (COPD) may develop hypercapnia and hypoxia, two main determinants of cerebral blood flow. The current authors tested whether cerebrovascular regulation was altered in mild COPD, modified by manoeuvres acutely improving autonomic cardiovascular modulation or influenced by smoking habit. In 15 eucapnic normoxic mild COPD patients (eight smokers) and 28 age-matched controls (14 smokers), midcerebral artery blood flow velocity (MCFV), end-tidal carbon dioxide tension (PET,CO 2), arterial oxygen saturation (Sa,O 2), ECG and blood pressure at rest were monitored during progressive hypercapnic hyperoxia, isocapnic hypoxia, slow breathing and oxygen administration. MCFV, arterial baroreflex and dynamic MCFV-blood pressure relationships were compared by phase analysis. COPD and control smokers showed higher MCFV (when corrected for PET,CO 2), lower cerebrovascular resistance index and lower sensitivity to hypercapnia than nonsmokers, with equal sensitivity to Sa,O 2 and similar phase analysis. Arterial baroreflex was depressed in all COPD patients. Slow breathing and oxygen administration improved baroreflex sensitivity and reduced MCFV in all COPD patients. Patients with mild chronic obstructive pulmonary disease show autonomic dysfunction. Chronic smoking induces cerebral vasodilation and impairs cerebrovascular control. All abnormalities can be partly corrected by improving the cardio- and cerebrovascular autonomic modulation, suggesting that functional autonomic abnormalities are already present at an early stage of disease. Copyright

Original languageEnglish
Pages (from-to)1458-1465
Number of pages8
JournalEuropean Respiratory Journal
Volume32
Issue number6
DOIs
Publication statusPublished - Dec 2008

Keywords

  • Baroreflex sensitivity
  • Cerebral circulation
  • Chronic obstructive pulmonary disease
  • Cigarette smoking
  • Hypercapnia
  • Hypoxia

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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