TY - JOUR
T1 - Effects of hypercapnia on peripheral vascular reactivity in elderly patients with acute exacerbation of chronic obstructive pulmonary disease
AU - de Matthaeis, Angela
AU - Greco, Antonio
AU - Dagostino, Mariangela Pia
AU - Paroni, Giulia
AU - Fontana, Andrea
AU - Vinciguerra, Manlio
AU - Mazzoccoli, Gianluigi
AU - Seripa, Davide
AU - Vendemiale, Gianluigi
PY - 2014/5/29
Y1 - 2014/5/29
N2 - Blood acid-base imbalance has important effects on vascular reactivity, which can be related to nitric oxide (NO) concentration and increased during hypercapnia. Release of NO seems to be linked to H+ and CO2 concentration and to exacerbation of chronic obstructive pulmonary disease (COPD), a common medical condition in the elderly. Flow-mediated dilation (FMD), a valuable cardiovascular risk indicator, allows assessment of endothelial-dependent vasodilation, which is to a certain extent mediated by NO. We investigated the effects of hypercapnia and acid-base imbalance on endothelial-dependent vasodilation by measurement of FMD in 96 elderly patients with acute exacerbation of COPD. Patients underwent complete arterial blood gas analysis and FMD measurement before (phase 1) and after (phase 2) standard therapy for acute exacerbation of COPD and recovery. Significant differences between phase 1 and phase 2 were observed in the mean values of pH (7.38±0.03 versus 7.40±0.02, P2 (59.6±4.9 mmHg versus 59.7±3.6 mmHg, P2 (59.3±8.63 mmHg versus 46.7±5.82 mmHg, P2 levels, passing from phase 1 to phase 2 (r = 0.23, P=0.023). Patients with higher baseline endothelium-dependent vasodilation as evaluated by FMD showed greater modification with regard to pCO2 changes (2.6±1.39 versus 1.59±1.4, P=0.012). In conclusion, endothelium-dependent vasodilation as evaluated by FMD was elevated during hypercapnia, and varied significantly according to pCO2 changes in patients with higher baseline levels, suggesting that vascular reactivity in acute COPD exacerbations in the elderly depends on integrity of the vascular endothelium.
AB - Blood acid-base imbalance has important effects on vascular reactivity, which can be related to nitric oxide (NO) concentration and increased during hypercapnia. Release of NO seems to be linked to H+ and CO2 concentration and to exacerbation of chronic obstructive pulmonary disease (COPD), a common medical condition in the elderly. Flow-mediated dilation (FMD), a valuable cardiovascular risk indicator, allows assessment of endothelial-dependent vasodilation, which is to a certain extent mediated by NO. We investigated the effects of hypercapnia and acid-base imbalance on endothelial-dependent vasodilation by measurement of FMD in 96 elderly patients with acute exacerbation of COPD. Patients underwent complete arterial blood gas analysis and FMD measurement before (phase 1) and after (phase 2) standard therapy for acute exacerbation of COPD and recovery. Significant differences between phase 1 and phase 2 were observed in the mean values of pH (7.38±0.03 versus 7.40±0.02, P2 (59.6±4.9 mmHg versus 59.7±3.6 mmHg, P2 (59.3±8.63 mmHg versus 46.7±5.82 mmHg, P2 levels, passing from phase 1 to phase 2 (r = 0.23, P=0.023). Patients with higher baseline endothelium-dependent vasodilation as evaluated by FMD showed greater modification with regard to pCO2 changes (2.6±1.39 versus 1.59±1.4, P=0.012). In conclusion, endothelium-dependent vasodilation as evaluated by FMD was elevated during hypercapnia, and varied significantly according to pCO2 changes in patients with higher baseline levels, suggesting that vascular reactivity in acute COPD exacerbations in the elderly depends on integrity of the vascular endothelium.
KW - Chronic obstructive pulmonary disease
KW - Elderly
KW - Flow-mediated dilation
KW - Hypercapnia
KW - Vascular reactivity
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U2 - 10.2147/CIA.S57548
DO - 10.2147/CIA.S57548
M3 - Article
C2 - 24904207
AN - SCOPUS:84901776778
VL - 9
SP - 871
EP - 878
JO - Clinical Interventions in Aging
JF - Clinical Interventions in Aging
SN - 1176-9092
ER -