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Recent Advances in Chest Medicine |

Arterial Stiffness in COPDArterial Stiffness in COPD

Isabelle Vivodtzev, PhD; Renaud Tamisier, MD, PhD; Jean-Philippe Baguet, MD, PhD; Jean Christian Borel, PhD; Patrick Levy, MD, PhD; Jean-Louis Pépin, MD, PhD
Author and Funding Information

From the Université Grenoble Alpes (Drs Vivodtzev, Tamisier, Borel, Levy, and Pépin); INSERM HP2 (U1042) (Drs Vivodtzev, Tamisier, Borel, Levy, and Pépin); Grenoble University Hospital (Drs Vivodtzev, Tamisier, Borel, Levy, and Pépin); and Department of Cardiology (Dr Baguet), Grenoble University Hospital, Grenoble, France.

Correspondence to: Jean-Louis Pépin, MD, PhD, Grenoble University Hospital, EFCR Laboratory, 29 Ave Maquis du Grésivaudan, La Tronche, Grenoble, France; e-mail: JPepin@chu-grenoble.fr


Funding/Support: This work was supported by grants from the scientific council of AGIRàdom.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(4):861-875. doi:10.1378/chest.13-1809
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In patients with COPD, cardiovascular diseases are the most common concomitant chronic diseases, a leading cause of hospitalization, and one of the main causes of death. A close connection exists between COPD and cardiovascular diseases. Cardiovascular risk scores aim to predict the effect of cardiovascular comorbidities on COPD mortality, but there is a need to better characterize occult and suboccult cardiovascular disease, even in patients with mild to moderate COPD. Among various surrogate markers of cardiovascular risk, arterial stiffness plays a central role and is a strong independent predictor of cardiovascular events beyond classic cardiovascular risk factors. Its measurement is highly suitable, validated, and relatively easy to perform in routine COPD clinical practice. The growing awareness of the increased cardiovascular risk associated with COPD has led to a call for respiratory physicians to measure arterial pulse wave velocity in routine practice. Cross-sectional data establish elevated arterial stiffness as being independently linked to COPD. Candidate mechanisms have been proposed, but surprisingly, only limited data are available regarding the impact of the different COPD treatment modalities on arterial stiffness, although initial studies have suggested a significant positive impact. In this review, we present the various surrogate markers of cardiovascular morbidity in COPD and the central role of arterial stiffness and the underlying mechanisms explaining vascular remodeling in COPD. We also consider the therapeutic impact of COPD medications and exercise training on arterial stiffness and the assessments that should be implemented in COPD care and follow-up.

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