Background: COPD is a systemic disease with associated comorbidities including cardiovascular disease which have significant impact on morbidity and mortality. The heterogeneity of COPD has led to the concept of phenotypes; one of which may describe patients at greater cardiovascular risk. Aortic pulse wave velocity (aPWV) is a validated measure of arterial stiffness and an independent predictor of cardiovascular outcomes, and has been shown to be elevated in patients with COPD.1 We hypothesised that a subgroup of patients (progressors) would demonstrate increased aPWV over 2 years. Methods: The ARCADE study is a longitudinal study of cardiovascular risk and other comorbidities. Assessments include spirometry, BMI, aPWV and blood pressure, (BP), mean arterial pressure (MAP), heart rate and 6 min walk distance (6MWT). Based on the change in PWV in hypertensive patients, progressors were defined as individuals with >0.5 m/s PWV increase, over 2 years.2 Results: Thus far 200 patients with COPD have completed the 2 year follow-up assessment. At baseline the progressor and non-progressor were similar in age, gender, BMI, heart rate and 6 MWT. However the progressors had greater airways obstruction, and lower mean arterial pressure and aPWV (Table 1). After 2 years the mean [95% CI] PWV change in progressors was +1.7 [2.0–1.5]m/s while FEV1 declined by 140 [76–206]ml (p < 0.05). In contrast the non-progressors had no change in lung function, while there was a decrease in aPWV 0.7 [0.5–0.9] m/s and MAP 5 [3–7] mmHg (p < 0.05). Conclusions: Almost half of the ARCADE subjects with COPD had a significant increase of PWV, the clinical relevance requires investigation using longer-term outcome data. The identification of CV risk phenotypes in COPD and the underlying pathophysiology may help identify novel therapeutic targets and improve CV outcomes for patients.
