Cardiovascular and musculoskeletal co-morbidities in patients with alpha 1 antitrypsin deficiency

Duckers, James, Shale, Dennis, Stockley, Robert A., Gale, Nichola S. ORCID: https://orcid.org/0000-0001-5207-9863, Evans, Bronwen Alice James ORCID: https://orcid.org/0000-0002-3082-1008, Cockcroft, John Ronald and Bolton, Charlotte E. 2010. Cardiovascular and musculoskeletal co-morbidities in patients with alpha 1 antitrypsin deficiency. Respiratory Research 11 (1) , 173. 10.1186/1465-9921-11-173

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Abstract

Background Determining the presence and extent of co-morbidities is fundamental in assessing patients with chronic respiratory disease, where increased cardiovascular risk, presence of osteoporosis and low muscle mass have been recognised in several disease states. We hypothesised that the systemic consequences are evident in a further group of subjects with COPD due to Alpha-1 Antitrypsin Deficiency (A1ATD), yet are currently under-recognised. Methods We studied 19 patients with PiZZ A1ATD COPD and 20 age, sex and smoking matched controls, all subjects free from known cardiovascular disease. They underwent spirometry, haemodynamic measurements including aortic pulse wave velocity (aPWV), an independent predictor or cardiovascular risk, dual energy X-ray absorptiometry to determine body composition and bone mineral density. Results The aPWV was greater in patients: 9.9(2.1) m/s than controls: 8.5(1.6) m/s, p = 0.03, despite similar mean arterial pressure (MAP). The strongest predictors of aPWV were age, FEV1% predicted and MAP (all p < 0.01). Osteoporosis was present in 8/19 patients (2/20 controls) and was previously unsuspected in 7 patients. The fat free mass and bone mineral density were lower in patients than controls (p < 0.001). Conclusions Patients with A1ATD related COPD have increased aortic stiffness suggesting increased risk of cardiovascular disease and evidence of occult musculoskeletal changes, all likely to contribute hugely to overall morbidity and mortality.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Healthcare Sciences Medicine
Subjects:	R Medicine > RM Therapeutics. Pharmacology
Publisher:	Biomed Central
ISSN:	1465-9921
Date of First Compliant Deposit:	30 March 2016
Last Modified:	11 Oct 2023 21:29
URI:	https://orca.cardiff.ac.uk/id/eprint/30832

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