Scichilone Nicola, Tuttolomondo Antonino, Maida Carlo, Benfante Alida, Peluso Jessica, Cirrincione Anna, Vassallo Valerio, Pinto Antonio
Dept of Biomedicine and Internal and Specialistic Medicine, DIBIMIS, University of Palermo, Palermo, Italy.
Both authors contributed equally.
ERJ Open Res. 2017 Jul 21;3(3). doi: 10.1183/23120541.00037-2017. eCollection 2017 Jul.
Chronic obstructive pulmonary disease (COPD) is associated with cardiovascular morbidity and mortality. Arterial stiffness and endothelial dysfunction index are validated surrogate cardiovascular markers and are increased in subjects with COPD. We tested whether increased arterial stiffness and endothelial dysfunction occur in symptomatic smokers with no evidence of bronchial obstruction. Clinical and lung functional assessments were conducted in smoker subjects with chronic respiratory symptoms and in COPD patients. Pulse wave velocity (PWV), aortic augmentation index (AIx) and reactive hyperaemia index (RHI) were measured to estimate the cardiovascular risk. 48 smokers (male n=37, female n=11; mean age 70±8.4 years) were studied. Smokers with respiratory symptoms without bronchial obstruction (n=13) did not differ from COPD patients (n=35) in terms of mean±sd PWV (12±3.2 m·s 14±3.8 m·s; p=0.10), aortic AIx (25.2±11.8% 24.8±9.7%, p=0.89) and RHI (1.66±1.49 1.62±1.43; p=0.79). The current investigation shows that the cardiovascular risk occurs in smokers with respiratory symptoms in the absence of bronchial obstruction. These findings need to be confirmed in larger populations in order to inform the design of intensive preventive programmes.
慢性阻塞性肺疾病（COPD）与心血管疾病的发病率和死亡率相关。动脉僵硬度和内皮功能障碍指数是经过验证的心血管替代标志物，在COPD患者中会升高。我们测试了在没有支气管阻塞证据的有症状吸烟者中是否会出现动脉僵硬度增加和内皮功能障碍。对有慢性呼吸道症状的吸烟者和COPD患者进行了临床和肺功能评估。测量脉搏波速度（PWV）、主动脉增强指数（AIx）和反应性充血指数（RHI）以评估心血管风险。共研究了48名吸烟者（男性n = 37，女性n = 11；平均年龄70±8.4岁）。没有支气管阻塞的有呼吸道症状的吸烟者（n = 13）与COPD患者（n = 35）在平均±标准差PWV（12±3.2m·s对14±3.8m·s；p = 0.10）、主动脉AIx（25.2±11.8%对24.8±9.7%，p = 0.89）和RHI（1.66±1.49对1.62±1.43；p = 0.79）方面没有差异。当前的研究表明，在没有支气管阻塞的有呼吸道症状的吸烟者中存在心血管风险。这些发现需要在更大规模的人群中得到证实，以便为强化预防计划的设计提供依据。
