RATIONALE: Chronic obstructive pulmonary disease (COPD) is associated with cardiovascular comorbidities. Studies conducted using GOLD 2011 guidelines (classifying COPD patients according to lung function, exacerbation history and symptoms) showed that more symptomatic patients were characterized by a higher burden of cardiovascular disease, affecting prognosis. Evidence exists that circulating endothelial microparticles (EMPs) increase in COPD patients. We investigated the relationship between circulating EMPs levels and COPD severity, evaluated by GOLD 2011 guidelines. Moreover, we examined the presence of cardiovascular disease in the same patients. METHODS: 24 COPD patients (Forced Expiratory Volume in 1 Second, median ± interquartile range: 1.53 ± 0.79 L, 58 ± 21% predicted) were enrolled in this observational, pilot study; they underwent clinical evaluation, complete pulmonary function tests, blood sampling for EMPs (both total levels and subgroups characterized according to the parental cellular origin: systemic or pulmonary derived), cardiovascular study including wave intensity measurement. The studied sample was arbitrarily divided into two groups according to the GOLD stages (group A+B+C: 19 subjects; group D: 5 subjects) and compared for EMPs and cardiovascular parameters. The outcomes were analysed using the Kolmogorov-Smirnov test. Data are presented as median ± interquartile range. RESULTS: A different profile emerged, in terms of circulating EMPs, between the two groups. Indeed, patients in group D showed significantly higher total and systemic EMPs levels than in the other group (total EMPs 16.0 ± 187.1 versus 9.1 ± 9.8 events/min for total EMPs, p=0.049; 15.4 ± 182.5 versus 8.4 ± 9.0 events/min, for systemic EMPs, p=0.049). Stage D patients also have a significantly higher basal heart rate than subjects in A+B+C group (76 ± 5 versus 65 ± 8 beats/min, p=0.042), and a strong trend (p=0.06) to a lower ventricular ejection time (240 ± 22 versus 264 ± 23 ms). CONCLUSIONS: Total and systemic-derived EMPs can represent biomarkers of higher severity of COPD, evaluated not only by expiratory function, but using a comprehensive classification, considering also symptoms and history of exacerbations. Furthermore, the higher severity of disease seems to be associated with a significant, though subclinical, cardiovascular impairment. Elevated levels of EMPs in stage D patients could be related to a greater cardiovascular injury in these subjects, but this hypothesis should be confirmed on a larger sample size.

Endothelial Microparticles as Potential Biomarkers of Severity and Cardiovascular Impairment in Chronic Obstructive Pulmonary Disease

Neri T;Morizzo C;Palombo C;Celi A;Paggiaro P
2018-01-01

Abstract

RATIONALE: Chronic obstructive pulmonary disease (COPD) is associated with cardiovascular comorbidities. Studies conducted using GOLD 2011 guidelines (classifying COPD patients according to lung function, exacerbation history and symptoms) showed that more symptomatic patients were characterized by a higher burden of cardiovascular disease, affecting prognosis. Evidence exists that circulating endothelial microparticles (EMPs) increase in COPD patients. We investigated the relationship between circulating EMPs levels and COPD severity, evaluated by GOLD 2011 guidelines. Moreover, we examined the presence of cardiovascular disease in the same patients. METHODS: 24 COPD patients (Forced Expiratory Volume in 1 Second, median ± interquartile range: 1.53 ± 0.79 L, 58 ± 21% predicted) were enrolled in this observational, pilot study; they underwent clinical evaluation, complete pulmonary function tests, blood sampling for EMPs (both total levels and subgroups characterized according to the parental cellular origin: systemic or pulmonary derived), cardiovascular study including wave intensity measurement. The studied sample was arbitrarily divided into two groups according to the GOLD stages (group A+B+C: 19 subjects; group D: 5 subjects) and compared for EMPs and cardiovascular parameters. The outcomes were analysed using the Kolmogorov-Smirnov test. Data are presented as median ± interquartile range. RESULTS: A different profile emerged, in terms of circulating EMPs, between the two groups. Indeed, patients in group D showed significantly higher total and systemic EMPs levels than in the other group (total EMPs 16.0 ± 187.1 versus 9.1 ± 9.8 events/min for total EMPs, p=0.049; 15.4 ± 182.5 versus 8.4 ± 9.0 events/min, for systemic EMPs, p=0.049). Stage D patients also have a significantly higher basal heart rate than subjects in A+B+C group (76 ± 5 versus 65 ± 8 beats/min, p=0.042), and a strong trend (p=0.06) to a lower ventricular ejection time (240 ± 22 versus 264 ± 23 ms). CONCLUSIONS: Total and systemic-derived EMPs can represent biomarkers of higher severity of COPD, evaluated not only by expiratory function, but using a comprehensive classification, considering also symptoms and history of exacerbations. Furthermore, the higher severity of disease seems to be associated with a significant, though subclinical, cardiovascular impairment. Elevated levels of EMPs in stage D patients could be related to a greater cardiovascular injury in these subjects, but this hypothesis should be confirmed on a larger sample size.
2018
https://www.atsjournals.org/doi/pdf/10.1164/ajrccm-conference.2018.197.1_MeetingAbstracts.A3134
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11568/940559
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