4508-4515-Epicardial fat thickness and COPD

Chronic obstructive pulmonary disease (COPD) is a type of lung disease characterized by progressive development of obstructed airflow and an increased chronic inflammatory response in the airways1. COPD is a major cause of morbidity and mortality worldwide2. The BODE index, is an important prognostic predictor of COPD, and is a multidimensional scoring system, combining information about various clinical factors; including Body-mass index (BMI), airflow Obstruction (forced expiratory volume in 1 s [FEV1]), Dyspnea (Medical Research Council [MRC] dyspnea scale), and Exercise capacity (6-min walk distance) in a score ranging from 0 to 101,3. This prognostic index predicts mortality significantly better than lung function the traditional prognostic COPD indicator-alone. The BODE index has made a contribution to the recognition, which prognostic evaluation of COPD patients should be extended beyond the lung function measurements2-4. Cardiovascular diseases are commonly encountered in patients with COPD. The link between cardiovascular disease (CVD) and COPD are particularly remarkable and clinically relevant, because, CVD is the most common comorbidity and a major cause of hospitalization in patients having mild to moderate COPD2,5. Many epidemiological studies have demonstrated that COPD doubles the risk of CVD hospitalization and morAbstract. – OBJECTIVE: Cardiovascular diseases (CVD) are common in patients with chronic obstructive pulmonary disease (COPD) and the BODE index is an important tool for the prognostic assessment of COPD patients. It is well known that epicardial fat thickness (EFT) is related to CVD. However, there are very few data about the relationship between EFT and BODE index. The aim of this study is to investigate the relationship between EFT and BODE index in patients with COPD. PATIENTS AND METHODS: We prospectively included 157 patients with COPD and 45 controls in the present study. All patients underwent pulmonary function tests and six-minute walking test. EFT and other echocardiographic parameters were measured using transthoracic echocardiography on admission. Patients were divided into four quartiles according to the BODE index scores (Quartile-1 (Q1): 0-2 points; Quartile-2 (Q2): 3-4 points; Quartile-3 (Q3): 5-6 points; Quartile-4 (Q4): 7-10 points). High sensitive C-reactive protein (Hs-CRP) and other biochemical parameters were measured in all participants. RESULTS: COPD patients had higher EFT values compared with control group (p<0.05). When COPD patients were classified according to BODE index quartiles, the highest EFT values were observed in Q1 compared with other quartiles (p<0.05, for all). EFT values showed a decreasing trend from Q1 to Q4. Furthermore, EFT was independently associated with BODE index (β=0.405, p<0.001), Hs-CRP (β=0.300, p<0.001) and diabetes (β=0.338, p<0.001) in multivariate linear regression analysis. CONCLUSIONS: Our findings suggested that EFT is independently and negatively associated with the severity of disease as indicated by BODE index in patients with COPD. European Review for Medical and Pharmacological Sciences 2016; 20: 4508-4515