Relationship Between Carotid Wall Thickness and Airflow Limitation in Chronic Obstructive Pulmonary Disease in Absence of Known Risk Factors of Atherosclerosis

• Main Authors: Mrityunjaya Singh, Govind Narayan Srivastava, Shruti Singh, Sudhir Kumar Agarwal, Ashish Verma
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2019-05-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: chronic airway disease; carotid atherosclerosis; forced expiratory volume; stroke
• Online Access: https://jcdr.net/articles/PDF/12871/40698_CE[Ra1]_F(KM)_PF1(AG_SHU)_PFA(SL)_PB(NC_AG)_PN(SL).pdf
• ISSN: 2249-782X; 0973-709X

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is characterised by chronic airway inflammation and concomitant systemic inflammation and associated with various comorbidities. Though cardiovascular complications have been most widely discussed, many studies over past two decades have identified stroke and carotid atherosclerosis to be associated with COPD. Some studies have postulated carotid atherosclerosis as a risk factor for impending stroke as well as a marker for cardiovascular complications. Aim: To evaluate carotid atherosclerosis in terms of carotid wall thickness (intima media thickness) in patients of COPD in absence of identifiable risk factors for carotid atherosclerosis. Materials and Methods: Patients admitted for acute exacerbation of COPD were screened for presence of carotid atherosclerois. Sixty seven patients were selected for study after meeting the inclusion criteria and after stabilisation of exacerbation were investigated by Color Doppler study of neck vessels and pulmonary function test. Distribution of data was tested for normalcy upon which parametric tests were used. Pearson correlation and one-way Anova tests were used using SPSS software. Results: Study included subjects more than 45 years (N=67). Mean age was 61.91±9.07 (Median=63.00). Airflow limitation was found to be of Grade IV in 55.2%, Grade III in 22.4% and Grade II in 22.4% of cases. Mean Carotid Intima Media Thickness (CIMT) was 1.19±0.35 mm. Strong inverse and significant correlation between FEV1-% Predicted (N=67, Mean 42.3, SD=14) and CIMT was found (Correlation coefficient (R) -0.696, p-value <0.001). FEV1/FVC % (N=67, Mean=58.4, SD=8.1). No significant correlation was seen with Body Mass Index (BMI) and Total Blood Cholesterol. Conclusion: Our study concluded that carotid atherosclerosis, quantified as CIMT, is inversely correlated to severity of airflow limitation in patients with COPD. The correlation is significant and studied in absence of factors which are known to be independent risk factors for atherosclerosis.