ArticleClinical interventions in aging2014
Effects of hypercapnia on peripheral vascular reactivity in elderly patients with acute exacerbation of chronic obstructive pulmonary disease.
Article in Clinical interventions in aging, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Reproducibility of cerebrovascular reactivity measurements: A systematic review of neuroimaging techniquesJournal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2022Pooled it
- Nociception monitors vs. standard practice for titration of opioid administration in general anesthesia: A meta-analysis of randomized controlled trials.Frontiers in medicine · 2022Pooled it
- Clinical assessment of endothelial function in patients with chronic obstructive pulmonary disease: a systematic review with meta-analysis.Internal and emergency medicine · 2017Pooled it
- Myxoedema Coma With Type 2 Respiratory Failure and Hypothermia in an Oedematous Patient: A Case Report.Cureus · 2026Article
- Electro-metabolic signaling.The Journal of general physiology · 2024Article
- Sympathetic vascular transduction and baroreflex sensitivity in the context of severe COPD.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2024Article
- Elevated Blood Pressure Occurs without Endothelial Dysfunction in a Rat Model of Pulmonary Emphysema.International journal of molecular sciences · 2023Article
- Pulmonary artery enlargement predicts poor survival in patients with COPD: A meta-analysis.Pulmonary circulation · 2022Article
- Response of TRPM2 Channel to Hypercapnic Acidosis and Role of Zn, Se, and GSH.Biological trace element research · 2022Article
- Association of exercise capacity and endothelial function in patients with severe exacerbations of chronic obstructive pulmonary disease.Scientific reports · 2021Observational
- Improved accuracy of cerebral blood flow quantification in the presence of systemic physiology cross-talk using multi-layer Monte Carlo modeling.Neurophotonics · 2021Article
- Association of Cardiovascular Health with Epicardial Adipose Tissue and Intima Media Thickness: The Kardiovize Study.Journal of clinical medicine · 2018Article
- Pulmonary Artery Enlargement Is Associated With Cardiac Injury During Severe Exacerbations of COPD.Chest · 2016Article
- Small pulmonary vascular alteration and acute exacerbations of COPD: quantitative computed tomography analysis.International journal of chronic obstructive pulmonary disease · 2016Article
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Blood acid-base imbalance has important effects on vascular reactivity, which can be related to nitric oxide (NO) concentration and increased during hypercapnia. Release of NO seems to be linked to H+ and CO2 concentration and to exacerbation of chronic obstructive pulmonary disease (COPD), a common medical condition in the elderly. Flow-mediated dilation (FMD), a valuable cardiovascular risk indicator, allows assessment of endothelial-dependent vasodilation, which is to a certain extent mediated by NO. We investigated the effects of hypercapnia and acid-base imbalance on endothelial-dependent vasodilation by measurement of FMD in 96 elderly patients with acute exacerbation of COPD. Patients underwent complete arterial blood gas analysis and FMD measurement before (phase 1) and after (phase 2) standard therapy for acute exacerbation of COPD and recovery. Significant differences between phase 1 and phase 2 were observed in the mean values of pH (7.38±0.03 versus 7.40±0.02, P<0.001), pO2 (59.6±4.9 mmHg versus 59.7±3.6 mmHg, P<0.001), pCO2 (59.3±8.63 mmHg versus 46.7±5.82 mmHg, P<0.001), FMD (10.0%±2.8% versus 8.28%±2.01%, P<0.001) and blood flow rate (1.5±0.3 m/s versus 1.5±0.3 m/s, P=0.001). FMD values were positively correlated with pCO2 values (r=0.294, P=0.004) at baseline. A significant correlation was also found between relative changes in FMD and pCO2 levels, passing from phase 1 to phase 2 (r=0.23, P=0.023). Patients with higher baseline endothelium-dependent vasodilation as evaluated by FMD showed greater modification with regard to pCO2 changes (2.6±1.39 versus 1.59±1.4, P=0.012). In conclusion, endothelium-dependent vasodilation as evaluated by FMD was elevated during hypercapnia, and varied significantly according to pCO2 changes in patients with higher baseline levels, suggesting that vascular reactivity in acute COPD exacerbations in the elderly depends on integrity of the vascular endothelium.
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