Reduced six-minute walking distance, high fat-free-mass index and hypercapnia are associated with endothelial dysfunction in COPD

Respir Physiol Neurobiol. 2012 Aug 15;183(2):128-34. doi: 10.1016/j.resp.2012.06.017. Epub 2012 Jun 18.


This study investigated the determinants of endothelial function in patients with chronic obstructive pulmonary disease (COPD). Digital pulse amplitude augmentation was measured by post-ischemic reactive hyperemia (RH-PAT) in 44 COPD patients and analyzed with covariates: condition vs. exacerbation, fat-free mass index (FFMI), pulmonary function, blood pressure, inflammation, six-minute walking distance, muscle function, medications, diabetes and prevalent cardiovascular diseases. RH-PAT was 0.43 (-0.14 to 1.30) with 50% of patients exhibiting abnormal RH-PAT ≤ 0.40. After adjustment for age and sex, RH-PAT was linked to condition, FFMI, myocardial infarction history, FEV(1), PaCO(2), heart rate, bicarbonates, inflammation and walking distance (p<0.10). In multivariate analysis, walking distance, FFMI and PaCO(2) were independent contributors of RH-PAT explaining 49% of the variance (p<0.0001). Higher FFMI was associated with higher inflammation, oxidative stress and endothelial dysfunction. Six-minute walking distance which is a widely available marker of severity and functional capacity in COPD patients is a main predictor of endothelial dysfunction.

Trial registration: NCT00404430.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Blood Pressure / physiology
  • Body Mass Index
  • Endothelium, Vascular / physiopathology*
  • Exercise Test / methods*
  • Female
  • Humans
  • Hypercapnia / physiopathology*
  • Hyperemia / physiopathology
  • Inflammation / physiopathology
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Myocardial Infarction / physiopathology
  • Oxidative Stress / physiology
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Respiratory Function Tests
  • Walking / physiology*

Associated data