Study of Carotid Intima-Media Thickness in Chronic Obstructive Pulmonary Disease in Sub-Himalayan Study Population

Authors : Rajan Vashisht, Dhiraj Kapoor, V.D. Dogra, Mukesh Surya

Volume/Issue : Volume 2 - 2017, Issue 5 - May

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BACKGROUND: The Chronic Obstructive Pulmonary Disease (COPD) is a systemic disease characterized by systemic inflammatory response (of lungs). The smoking is most important factor in etio pathogenesis of COPD. The COPD patients are at threefold increased risk of Coronary Artery Disease(CAD)/Cerebrovascularla Accidents(CVA). The Carotid Intima-Media Thickness (CIMT) is known surrogate marker for pre-atherosclerosis, hence also for CAD/CVA. Hence, the CIMT can be measured as marker for CAD/CVA in COPD. MATERIAL and METHODS: All participants were classified on pulmonary function test (PFT). The participants with normal PFTs were controls and rest were patients with COPD. The respiratory disorders other than COPD, recent surgery, endocrinal (including Diabetes), renal and hepatic diseases, hypertension and the coronary artery disease were clinically excluded from the study. The SPIROLAB III device used for PFTs. The Philips Doppler machine used for measuring CIMT. The CIMT 0.8 mm or more is taken as hypertrophy. Also plaques were measured separately. AIM and OBJECTIVE: To study Carotid Intima-Media Thickness in COPD among patients from sub Himalayan region. RESULTS: Out of total participants (n=90) sixty were COPD patients. The COPD patients were divided into moderate and severe stage of COPD (i.e. 30 each).Rest of participants were controls with normal pulmonary function tests (n=30). The mean age of participants was 68.33 ± 9.88 years among patients with stage II (Moderate) COPD and 63.87 ±9.79 years among patients stage III/IV (severe/very severe) COPD respectively. The mean age of controls with normal PFTs were 66.36 ±10.76 years. The CIMT in COPD patients was found significantly to be higher than healthy controls. The mean CIMT was 0.572mm ± 0.06, 0.816mm ± 0.13 and 0.738mm ± 0.12 in normal controls, stage II and stage III respectively. The age was found to be independent predictor of CIMT. The FEV1/FVC ratio and FEV1 measurements were negatively related with CIMT and hence also with atherosclerosis. The plaques seen in 10 out of 60 (i.e. 16.6%) COPD patients with low socioeconomic status and of rural background can been taken as important finding for deciding management of COPD patients. (P=0.039). CONCLUSION: This is the first study evaluating the CIMT in COPD patients with rural background from subHimalayan population. The COPD patients without known risk factors of hypertension, diabetes or dyslipidaemia were found with higher CIMT values consistent with the view that the COPD patients were at increased risk for CAD and cerebrovascular disease.


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