Pulmonary emphysema and atherosclerosis: association or syndrome?

Abstract

Background

Atherosclerosis is an inflammatory reaction of the vessel wall. Emphysema may induce systemic inflammation, part of which may be the development or progression of atherosclerosis. So, the relationship between emphysema and atherosclerosis, whether both are due to the same causative agent and pathogenesis or emphysema led to atherosclerosis, is still not clearly understood. So, the aim of this work is to study the relationship between carotid atherosclerosis versus pulmonary emphysema extent and airflow obstruction.

Results

Cigarette smoking index was higher in patients than controls. According to FEV1%, patients were classified into: GOLD 1 (mild): FEV1 ≥ 80% predicted, GOLD 2 (moderate): 50% ≤ FEV1 < 80% predicted, GOLD 3 (severe):30% ≤ FEV1 < 50% predicted, and GOLD 4 (very severe): FEV1 < 30% predicted. There was a significant difference between the studied groups as regard to ABG parameters. Emphysema score showed a positive correlation with thrombus size, plaque size, and stenosis percent. Approximately 2/3 of patients had atherosclerotic changes and the other 1/3 had increased IMT. GOLD staging, also, correlated with thrombus size and stenosis percent. So, there was a strong positive correlation between both emphysema score and GOLD staging and carotid atherosclerosis.

Conclusion

The relationship between emphysema and atherosclerosis is suggested to be the chronic inflammatory reaction (against the same risk factor) based on the positive correlation between carotid atherosclerosis versus emphysema score and GOLD staging. The inherence of emphysema and atherosclerosis may be considered a syndrome. If so, targeting the same pathogenic mechanism will be valuable for their control.