Evidence of impaired spontaneous baroreceptor sensitivity in patients with COPD as a potential link to cardiovascular morbidity and mortality
2012
Objectives: Recent studies suggest reduced cardiac filling pressures in patients with COPD due to hyperinflation. A reduction in cardiac preload may result in unloading of baroreceptors. We thus investigated spontaneous baroreceptor sensitivity, an independent predictor of cardiovascular morbidity and mortality, in patients with COPD and controls.
Methods: 33 patients with severe airflow obstruction but free from clinical cardiovascular disease (age 64±7yrs, BMI 23±4 kg/sqm, FEV1 27±7%, TLC 140±19%) and 12 age, gender, and body-weight matched controls without airflow obstruction were studied. Spontaneous baroreceptor activity was measured using the sequence method during resting conditions. The baroreceptor effectiveness index was calculated from the total number of baroreceptor sequences divided by the total number of systolic blood pressure ramps.
Results: The mean slope of spontaneous baroreceptor sequences (7.0±4.7msec/mmHg vs. 13.5±6.4msec/mmHg, p<0.01) and the baroreceptor effectiveness index (71±54 vs. 103±34, p<0.05) were significantly lower in patients with COPD than controls. There was a significant inverse relationship between the slope of baroreceptor sensitivity (r = -0.302, p < 0.05) and baroreceptor effectiveness index (r = - 0.391, p < 0.01) with RV/TLC ratio. There were no such associations with airflow obstruction.
Conclusions: Our findings indicate a link between hyperinflation and baroreceptor function in patients with COPD.
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