Original Research Article
Year: 2019 | Month: April-June | Volume: 4 | Issue: 2 | Pages: 57-63
Effect of Physiological and Clinical Variables of Chronic Obstructive Pulmonary Disease on Atherosclerosis
Mrityunjaya Singh1, Shruti Singh2, Govind Narayan Srivastava3, Ashish Verma4
1Assistant Professor, Dept of Respiratory Medicine, School of Excellence in Pulmonary Medicine, NSCB Medical College, Jabalpur.
2Resident, Dept of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi.
3Professor, Dept of TB & Respiratory Diseases, Institute of Medical Sciences, Banaras Hindu University, Varanasi.
4Associate Professor, Dept of Radiodiagnosis & Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi.
Corresponding Author: Shruti Singh
ABSTRACT
Background: Chronic obstructive pulmonary disease (COPD) is a debilitating condition associated with significant morbidity and mortality. Cardiovascular diseases are the major cause of mortality in COPD patients. Studies have shown that increased airflow limitation in COPD patients is associated with increased risk of atherosclerotic heart diseases. FEV1 has been shown to correlate significantly with carotid atherosclerosis as a marker of cardiovascular disease risk. This study tries to study the effect of physiological and clinical variables of COPD on atherosclerosis in terms of carotid intima media thickness.
Method:Patients admitted for acute exacerbation of COPD to our hospital were evaluated for carotid atherosclerosis, quantified by common carotid intima media thickness. 67 patients with significant CCIMT; quantified using B-mode ultrasonography and color doppler were evaluated in respect to physiological and clinical variables. Pearson’s correlation, multiple linear regression, Anova and Independent sample t-tests were used, depending upon type of variable under test using IBM-SPSS software version17.
Results: Study included 67 subjects [Mean age = 61.91±9.07, Median = 63.00] including 38 males and 29 females of age 45 years and above. Mean common carotid intima media thickness (CCIMT) was 1.19 ± 0.35 mm. Lung function (represented by FEV1 % predicted, FEV1/FVC and PEFR) showed significant inverse correlation with CC=-IMT (p-value<0.05). Significant positive correlation was found between CC-IMT and age, arterial partial pressure of carbon di-oxide, total duration of illness (TDI) (p-value<0.01) and significant inverse correlation was seen with % of TDI on Proper monitored inhalation therapy. No significant correlation was found between arterial partial pressure of oxygen (PaO2) and CC-IMT. Multiple linear regression analysis shows that PaCO2 (p-Value = 0.001) and Total Duration of Illness; TDI (p-Value < 0.001) are the two independent variables that have significant impact in predicting the CC-IMT.
Conclusion: our study shows that total duration of disease and PaCO2 is associated with increased carotid atherosclerotic thickening in COPD patients among all other physiological variables. Early diagnosis and management of COPD and early screening of atherosclerotic vascular heart disease in COPD patients may help reduce risk of atherosclerotic vascular complication.
Key words: COPD, CC-IMT, Carotid atherosclerosis, PaCO2, FEV.