Endothelial Dysfunction in Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD)
Endothelial Dysfunction in Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD)
The purpose of the study is to determine a possible association between the clinical entity
 of exacerbation, markers of systemic inflammation and endothelial dysfunction in patients
 with COPD.
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease of the lungs;
 however, there is cumulating data suggesting that the inflammatory reaction associated with
 COPD is not restricted to the lungs but has systemic effects. Patients with COPD have
 increased cardiovascular morbidity and mortality. The suspected link between increased
 cardiovascular mortality and systemic inflammation is endothelial dysfunction, which in turn
 is caused by impaired activity of NO. Endothelial dysfunction has been demonstrated in
 patients with COPD. Furthermore there is a close correlation between endothelial dysfunction
 in coronary and peripheral vessels, which allows assessing flow-mediated dilation (FMD) in
 the brachial artery via high resolution ultrasound as an early predictor of atherosclerosis.
 Moreover, systemic inflammatory markers correlate with endothelial dysfunction in patients
 with stable COPD.

 Exacerbations of COPD are episodes of worsening symptoms characterized by increased airway
 and systemic inflammation. If systemic inflammation is a cause of endothelial dysfunction in
 COPD, endothelial function would be suspected to be further impaired during exacerbation and
 recover thereafter. The purpose of this study is to determine a possible association between
 the clinical entity of exacerbation, markers of systemic inflammation and endothelial
 dysfunction in patients with COPD.
Inclusion Criteria:

 -  presence of COPD according to standard criteria

 -  acute exacerbation of COPD according to recommended international criteria

 -  over 40 years of age

 -  history of at least 10 py

 Exclusion Criteria:

 -  pneumonia

 -  history or signs of congestive heart failure,

 -  acute myocardial infarction

 -  thoracotomy incl. resection of lungtissue

 -  interstitial lung disease

 -  acute or chronic renal failure

 -  active malignancy

 -  autoimmune disease