• Thibaud Soumagne, Nicolas Roche, Alicia Guillien, Malika Bouhaddi, Steffi Rocchi, Sophie Hue, Frédéric Claudé, Lucie Bizard, Pascal Andujar, Jean-Charles Dalphin, and Bruno Degano.
• Service de Physiologie-Explorations Fonctionnelles, Centre Hospitalier Universitaire Besançon, Besançon, France; Service de Pneumologie, Centre Hospitalier Universitaire Besançon, Besançon, France. Electronic address: thibaud_soumagne@live.fr.
• Chest. 2020 Apr 1; 157 (4): 834-845.

BackgroundThe observation that COPD is an independent risk factor for cardiovascular disease (CVDs) comes from comparisons between smokers with COPD and smokers without COPD. The mechanisms that explain increased risk of CVD in patients with COPD are still unclear.ObjectivesThe goal of this study was to assess systemic arterial stiffness (a predictor of CVD mortality) and to evaluate its determinants in a group of patients with mild to moderate COPD secondary to organic dust exposure, tobacco smoking, or both.MethodsSystemic arterial stiffness was assessed by using aortic pulse wave velocity (aPWV). Measurements were made in 142 patients with COPD and 155 healthy control subjects matched for age, sex, BMI, and tobacco smoking, exposed to tobacco smoking (n = 56/70 for COPD/control subjects, respectively), organic dusts (n = 44/48), or both (n = 42/37).ResultsaPWV was higher in COPD than in healthy controls in subjects exposed to tobacco smoking and to both organic dusts and tobacco smoking. By contrast, among never smokers exposed to organic dusts, patients with COPD and matched control subjects had similar aPWV. Multivariate analysis of the 142 patients with COPD (exposed to tobacco smoking and/or to organic dusts) showed that tobacco smoking was associated with high aPWV. Moreover, soluble suppression of tumorigenicity 2, a marker of major cardiovascular events, was correlated with aPWV in these patients.ConclusionsAnalysis of an unselected group of patients with COPD with different causes suggests that: (1) COPD by itself is not sufficient to explain increased aPWV; and (2) tobacco smoking is a risk factor for elevated aPWV in COPD.Copyright © 2019 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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