| Autonomic and cerebrovascular abnormalities in mild COPD are worsened by chronic smoking. | |
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MedLine Citation:
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PMID: 18799508 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Patients with chronic obstructive pulmonary disease (COPD) may develop hypercapnia and hypoxia, two main determinants of cerebral blood flow. The current authors tested whether cerebrovascular regulation was altered in mild COPD, modified by manoeuvres acutely improving autonomic cardiovascular modulation or influenced by smoking habit. In 15 eucapnic normoxic mild COPD patients (eight smokers) and 28 age-matched controls (14 smokers), midcerebral artery blood flow velocity (MCFV), end-tidal carbon dioxide tension (P(ET,CO2)), arterial oxygen saturation (S(a,O2)), ECG and blood pressure at rest were monitored during progressive hypercapnic hyperoxia, isocapnic hypoxia, slow breathing and oxygen administration. MCFV, arterial baroreflex and dynamic MCFV-blood pressure relationships were compared by phase analysis. COPD and control smokers showed higher MCFV (when corrected for P(ET,CO2)), lower cerebrovascular resistance index and lower sensitivity to hypercapnia than nonsmokers, with equal sensitivity to S(a,O2) and similar phase analysis. Arterial baroreflex was depressed in all COPD patients. Slow breathing and oxygen administration improved baroreflex sensitivity and reduced MCFV in all COPD patients. Patients with mild chronic obstructive pulmonary disease show autonomic dysfunction. Chronic smoking induces cerebral vasodilation and impairs cerebrovascular control. All abnormalities can be partly corrected by improving the cardio- and cerebrovascular autonomic modulation, suggesting that functional autonomic abnormalities are already present at an early stage of disease. |
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Authors:
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L Bernardi; G Casucci; T Haider; E Brandstätter; E Pocecco; I Ehrenbourg; M Burtscher |
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Publication Detail:
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Type: Journal Article Date: 2008-09-17 |
Journal Detail:
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Title: The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology Volume: 32 ISSN: 1399-3003 ISO Abbreviation: Eur. Respir. J. Publication Date: 2008 Dec |
Date Detail:
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Created Date: 2008-12-01 Completed Date: 2009-05-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8803460 Medline TA: Eur Respir J Country: Switzerland |
Other Details:
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Languages: eng Pagination: 1458-65 Citation Subset: IM |
Affiliation:
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Dept of Internal Medicine, University of Pavia and IRCCS Hospital San Matteo, Pavia, Italy. lbern1ps@unipv.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anoxia Baroreflex Carbon Dioxide / metabolism Case-Control Studies Cerebrovascular Circulation Cerebrovascular Disorders / complications, physiopathology* Female Humans Hyperoxia Male Middle Aged Oxygen / metabolism Pulmonary Disease, Chronic Obstructive / complications, physiopathology* Smoking* |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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