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Am J Physiol Lung Cell Mol Physiol 274: L908-L913, 1998;
1040-0605/98 $5.00
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Vol. 274, Issue 6, L908-L913, June 1998

Endothelial dysfunction in pulmonary arteries of patients with mild COPD

Víctor I. Peinado, Joan A. Barberà, Josep Ramírez, Federico P. Gómez, Josep Roca, Lluís Jover, Josep M. Gimferrer, and Robert Rodriguez-Roisin

Departments of Respiratory Medicine, Pathology, and Thoracic Surgery, Institut d'Investigacions Biomèdiques Pi i Sunyer, Hospital Clínic, and Biostatistics Unit, Department of Public Health, School of Medicine, University of Barcelona, 08036 Barcelona, Spain

To investigate whether endothelial dysfunction of pulmonary arteries (PA) is present in patients with mild chronic obstructive pulmonary disease (COPD) and to what extent it is related to the morphological abnormalities of PA, we studied 41 patients who underwent lung resection. Patients were divided into the following groups: nonsmokers (n = 7), smokers with normal lung function (n = 13), and COPD (n = 21). Endothelium-dependent relaxation mediated by nitric oxide was evaluated in vitro in PA rings exposed to cumulative concentrations of acetylcholine (ACh) and ADP. Structural abnormalities of PA were assessed morphometrically. PA of COPD patients developed lower maximal relaxation in response to ADP than both nonsmokers and smokers (P < 0.05 each) and a trend to reduced relaxation in response to ACh (P = 0.08). Maximal relaxation to ADP correlated with the degree of airflow obstruction (r = 0.48, P < 0.01). Morphometrical analysis of PA revealed thicker intimas, especially in small arteries, in both smokers and COPD compared with nonsmokers (P < 0.05 each). We conclude that endothelial dysfunction of PA is already present in patients with mild COPD. In these patients, as well as in smokers with normal lung function, small arteries show thickened intimas, suggesting that tobacco consumption may play a critical role in the pathogenesis of pulmonary vascular abnormalities in COPD.

endothelium; intimal layer; nitric oxide; pulmonary circulation; tobacco smoking


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