Cardiovascular and musculskeletal co-morbidities in patients with alpha 1 antitrypsin deficiencyReportar como inadecuado

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Respiratory Research

, 11:173

First Online: 07 December 2010Received: 01 October 2010Accepted: 07 December 2010


BackgroundDetermining the presence and extent of co-morbidities is fundamental in assessing patients with chronic respiratory disease, where increased cardiovascular risk, presence of osteoporosis and low muscle mass have been recognised in several disease states. We hypothesised that the systemic consequences are evident in a further group of subjects with COPD due to Alpha-1 Antitrypsin Deficiency A1ATD, yet are currently under-recognised.

MethodsWe studied 19 patients with PiZZ A1ATD COPD and 20 age, sex and smoking matched controls, all subjects free from known cardiovascular disease. They underwent spirometry, haemodynamic measurements including aortic pulse wave velocity aPWV, an independent predictor or cardiovascular risk, dual energy X-ray absorptiometry to determine body composition and bone mineral density.

ResultsThe aPWV was greater in patients: 9.92.1 m-s than controls: 8.51.6 m-s, p = 0.03, despite similar mean arterial pressure MAP. The strongest predictors of aPWV were age, FEV1% predicted and MAP all p < 0.01. Osteoporosis was present in 8-19 patients 2-20 controls and was previously unsuspected in 7 patients. The fat free mass and bone mineral density were lower in patients than controls p < 0.001.

ConclusionsPatients with A1ATD related COPD have increased aortic stiffness suggesting increased risk of cardiovascular disease and evidence of occult musculoskeletal changes, all likely to contribute hugely to overall morbidity and mortality.

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Autor: James M Duckers - Dennis J Shale - Robert A Stockley - Nichola S Gale - Bronwen AJ Evans - John R Cockcroft - Charlott


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