Endotelna funkcija i fenotipska obilježja bolesnika s kroničnom opstrukcijskom plućnom bolesti sklonih čestim egzacerbacijama [Endothelial function and phenotypic characteristics of patient with chronic obstructive pulmonary disease and frequent exacerbations]

Abstract

The „frequent egzacerbator“ is a COPD phenotype characterised with severe clinical course and with increased risk for cardiovascular mortality. The systemic inflammation play a key role in the pathogenesis of COPD and endothelial dysfunction is a suspected link between increased cardiovascular mortality and systemic inflammation in COPD patients.So far, systematic studies of endothelial dysfunction in two phenotypically distinct groups of COPD patients has not been done. The study recruited 117 participants. COPD patients were divided into two groups according to the criteria of frequency of acute egzacerbation: 41 frequent egzacerbator and 41 infrequent egzacerbator. The control group consists of 35 healthy smokers. In all three groups were determined markers of endothelial dysfunction ( ET-1,vWF) and of systemic inflammation ( WBC, fibrinogen, CRP). We conducted pulmonary function test and 6-MWT-minute walking test, and calculated BODE indeks. Endothelial function was assessed by FMD. The results were statistically analyzed. Frequent exacerbator had more severe airway obstruction and higher degree of sistemic inflammation and endothelial dysfunction, with higher symptom score and BODE index.We believe that our research will represent a significant contribution to better understanding, early detection and adequate treatment of these groups of COPD patient