Effects of hypercapnia on peripheral vascular reactivity in elderly patients with acute exacerbation of chronic obstructive pulmonary disease

Angela de Matthaeis, Antonio Greco, Mariangela Pia Dagostino, Giulia Paroni, Andrea Fontana, Manlio Vinciguerra, Gianluigi Mazzoccoli, Davide Seripa, Gianluigi Vendemiale

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)871-878
Number of pages8
JournalClinical Interventions in Aging
Volume9
DOIs
Publication statusPublished - May 29 2014

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Keywords

  • Chronic obstructive pulmonary disease
  • Elderly
  • Flow-mediated dilation
  • Hypercapnia
  • Vascular reactivity

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Medicine(all)

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