Association Between Right Heart Failure And Endothelial Dysfunction In Copd Patients

Introduction: COPD is characterized by persistent respiratory symptoms due to chronic particle exposure. The prevalence of COPD is 3 to 6% in >50 years old. In COPD and endothelial dysfunction (ED), there is an increase in capillary permeability that causes edema, at the pulmonary level generates a dysfunction in the gaseous exchange with increased ratio pO2/FiO2; in the cardiovascular level intravascular coagulation, thrombus, and myocardial dysfunction. The prevalence of HF in COPD patients is 21%. Objective: To evaluate the association between ED and the risk of HF in COPD patients. Material and Methods: Cross-sectional study, patients >40 years old with COPD diagnosis were included, patients with asthma, HIV were excluded. The endothelial function was evaluated by photoplestimography: where a maximum amplitude/total time (MAT/TT) >0.30 was considered ED. They were divided into 2 groups according to endothelial function. Logistic regression was performed to assess the risk of right HF. Results: 287 patients were evaluated, 51.2% male, age was 71.6 ± 10.2. The prevalence of ED was 74.2%. Differences were found with a tendency to statistical significance in: age 71.3 ± 10.4 vs 72.2 ± 9.7 (p= 0.525), GOLD 2 (29.7 % vs 37.7%, p=0.101), GOLD 3 (19.4% vs 26.4%, p=0.101), heart disease 27.7% vs 17.6% (p=0.083), vascular brain disease 3.8% vs 0% (p=0.090), pulmonary hypertension 18.8% vs 10.8% (p=0.114), in the ED group compared to patients without ED, respectively. Patients with ED have a 3 times higher risk of having RHF (OR 4.02, IC95%; 0.88 – 18.20, p=0.071). Conclusions: ED in COPD patients increases the risk of developing the right HF.