Pulmonary function correlates with arterial stiffness in asthmatic patients

Summary 

Background

At the population level, asthma has been associated with chronic systemic inflammation as well as adverse cardiovascular outcomes.

Objectives

The aim of this study was to investigate peripheral vascular hemodynamic variables of arterial stiffness (AS) and their relationship to pulmonary function tests in asthmatic patients.

Methods

Young asthmatic patients from the tertiary center for pulmonary diseases at the Barzilai Medical Center underwent pulmonary function evaluation and non-invasive radial artery hemodynamic profiling, pre- and post-exercise. Results were compared to age matched, non-asthmatic controls.

Results

23 young asthmatics and 41 controls, completed all evaluation points. Pulmonary flow parameters were significantly reduced in the asthma group at all points. There were no differences between groups in BMI, blood pressure, pulse rate or measurements of AS at baseline or after bronchodilation. The % predicted forced expiratory volume in the first second at baseline (FEV1%) in asthmatics was positively correlated with the small arteries elasticity index (SAEI) and negatively correlated with the systemic vascular resistance (SVR) in these patients. These correlations were not observed in non-asthmatic controls. In multifactorial regression FEV1 remained the major factor associated with measurements of AS in asthmatic patients, while gender was the only significant factor in non-asthmatic controls.

Conclusions

Significant correlations between measurements of AS and FEV1 in young asthmatics, suggest the presence of a common systemic, most likely inflammatory pathway involving both the cardiovascular and respiratory systems.

Keywords: Asthma, Arterial stiffness, Pulmonary function, Adult

Abbreviations: ANOVA, analysis of variance, BMI, body mass index, CRP, C-reactive protein, DBP, diastolic blood pressure, CET, estimated cardiac ejection time, ECI, estimated cardiac index, ECO, estimated cardiac output, ECT, exercise challenge tests, ESV, estimated stroke volume, ESVI, estimated stroke volume index, FEV1, forced expiratory volume in the first second, FEV1%, % predicted forced expiratory volume in the first second, LAEI, large artery elasticity index, MAP, mean arterial BP, Mch, methacholine, MCTs, methacholine challenge tests, PFTs, pulmonary function tests, PP, pulse pressure, PR, pulse rate, SAEI, small artery elasticity index, SBP, systolic blood pressure, SVR, systemic vascular resistance, TVI, total vascular impedance