Endothelial dysfunction: The possible link between cardiovascular comorbidities and phenomenon of inflammaging from COPD

Abstract

Aging is a risk factor for many chronic noncommunicable diseases, including chronic obstructive pulmonary disease (COPD), which is often associated with cardiovascular disease (CVD). Moreover, aging is associated with a mild form of systemic inflammation. The aim of our study was to analyze the relationship between age, systemic and vascular inflammation, and the presence of CVD comorbidities in a stable COPD population. Forty COPD patients were divided into 2 age groups (<65 and ≥65 years of age), from which we collected the following inflammatory biomarkers: C-reactive protein, tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), and endothelin-1 (ET-1). Elderly COPD patients had more frequent exacerbation events per year (2 vs 1, P = .06), a higher prevalence of CVD (3 vs 2, P = .04), more limited exercise tolerance (6-minute walking test distance, 343 [283-403] vs 434 [384-484]; P = .02), and mild systemic inflammation (TNF-α, 9.02 [7.08-10.96] vs 6.48 [5.21-7.76]; P = .03; ET-1, 2.24 [1.76-2.71] vs 1.67 [1.36-1.98] pg/mL; P = .04). A weak correlation between age and ET-1 (r = 0.32, P = .04) was observed. Mild systemic inflammation, characterized by a slightly increased level of TNF-α, and endothelial dysfunction, marked by elevated ET-1, could be liaisons between aging, COPD, and CVD comorbidities.

Figure 1.

Age correlation with CRP and IL-6 in COPD patients. COPD = chronic obstructive pulmonary disease, CRP = C-reactive protein, IL-6 = interleukin-6.

Figure 2.

Age correlation with TNFα and ET-1 in COPD patients. COPD = chronic obstructive pulmonary disease, ET-1 = endothelin-1, TNFα = tumor necrosis factor alpha.

Figure 3.

FEV1 (%) correlations with analyzed biomarkers in COPD patients: CRP; IL-6; TNF-α; ET-1. COPD = chronic obstructive pulmonary disease, CRP = C-reactive protein, ET-1 = endothelin-1, FEV1 = Forced Expiratory Volume in the first second, IL-6 = interleukin-6, TNF-α = tumor necrosis factor alpha.