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  1. Thank you for viewing this presentation. • We would like to remind you that this material is the property of the author. It is provided to you by the ERS for your personal use only, as submitted by the author. • 2008 by the author

  2. Is COPD a risk factor for increased arterial stiffness? Julie Hjortsø Janner Dept. of Cardiology and Respiratory Medicine Hvidovre University Hospital Copenhagen, Denmark Conflicts of Interest: None

  3. COPD and CVD • High risk of CVD is a consequence of COPD? • Arterial stiffness predicts CVD • Measurements of arterial stiffness: • Pulse wave velocity - PWV • Augmentation index – AIx

  4. Pulse wave analysis Systolic pressure Augmentation pressure (AP) Pulse pressure (PP) Diastolic pressure AIx75 = AP / PP (corrected for heart rate)

  5. COPD and arterial stiffness • PWV, AIx and augmentation pressure are increased in patients with COPD R. Sabit et al. Am J Respir Crit Care Med 2007;175:1259-1265 NL. Mills et al. Thorax 2008;63:306-311 • PWV is increasing with emphysema severity in patients with COPD D. McAllister et al. Am J Respir Crit Care Med 2007;176:1208-1214 • Conflicting results regarding PWV association with FEV1 in the general population M. Zureik et al. Am J Respir Crit Care Med 2001;164:2181-2185 K.Taneda et al. Clin Exp Pharmacol Physiol 2004;31:S31-S34

  6. Hypothesis - Objective • Decrease in lung function is associated with increase in AIx75 • Examine the association between COPD, lung function (FEV1, FVC) and arterial stiffness measured by AIx75

  7. Methods • Copenhagen City Heart Study – 6300 subjects • COPD: • FEV1/FVC < 70 % • Age > 40 years • No astma • 849 subjects with COPD • 550 subjects with COPD (moderate to severe) and measurements of AIx75

  8. AIx75 - COPD AIx75 AIx75

  9. AIx75 – COPD: linear regression model Effect Of COPD Crude Crude

  10. AIx75 – COPD: linear regression model Effect Of COPD Crude Crude Crude Crude Partly adjusted Model 1 Partly adjusted Model 1 Model 2 Model 2

  11. AIx75 – COPD: linear regression model Effect Of COPD Crude Crude Partly adjusted Partly adjusted Fully adjusted Fully adjusted

  12. AIx75 – FEV1: Generalised additive model Men AIx75 (Diff. from mean) FEV1 (L/min)

  13. AIx75 – FEV1: Generalised additive model Men Women AIx75 (Diff. from mean) FEV1 (L/min)

  14. Conclusion • COPD is NOT associated with AIx75 after controlling for confounders • This could be due to: • No association of arterial stiffness and COPD • AIx75 is an inadequate measurement of arterial stiffness in subjects with COPD

  15. Thank you for your attention • The work has been done in cooperation with: • NS. Godtfredsen – Dept. of Respiratory Medicine, Bispebjerg University Hospital, Copenhagen, Denmark • E. Prescott – Dept. of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark • D. McAllister – ELEGI/Colt Laboratories, MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom • J. Vestbo – Dept. of Cardiology and Respiratory Medicine, Hvidovre University Hospital, Hvidovre, Denmark • Funding: • The Danish Lung Association • The Danish Heart Foundation (08-4-R64-A1992-B808-22466) • The Danish Cardiovascular Research Academy (DaCRA). • ERS (Short-term fellowship)

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