Central pulsatile haemodynamics in COPD - a propensity score-matched evaluation of cohorts

Background Cardiovascular risk is elevated in patients with COPD. Central haemodynamic measurements via wave separation analysis indicate cardiovascular risk independent of well-known limitations of peripheral blood pressure measurements, but have not been studied in COPD yet. We aimed to investigate central haemodynamics and their association with lung function in patients with COPD. Methods In this cross-sectional evaluation of cohort studies, we used propensity score matching to compare COPD patients from the randomized ELASTIC trial (n=80) to subjects without airflow limitation and cardiovascular diseases from the Heinz Nixdorf Recall study (n=2307) and the Heinz Nixdorf Multi-Generation study (n=2625). Central haemodynamics were measured noninvasively via wave separation analysis. Forward wave amplitude (FWA) and backward wave amplitude (BWA) were compared between patients and controls matched for age, sex, hypertension and smoking, and were assessed for associations with lung hyperinflation. Results From the initial study cohorts, we identified 75 pairs of COPD patients and matched controls. We found greater FWA in patients than in matched controls (Cohen's d and 95% CI: 0.423 [0.098–0.746]). BWA was greater in patients than in unmatched controls (Cohen's d and 95% CI: 0.333 [0.104–0.562], but did not differ after matching (Cohen's d and 95% CI: 0.128 [−0.193–0.448]). On multivariable regression FWA was independently associated with hyperinflation expressed as RV/TLC-ratio (standardized ß: −0.188, 95%CI: −0.335 – −0.037) in patients with COPD. Conclusion COPD is associated with greater FWA which may contribute to increased cardiovascular risk and appears to be correlated with the degree of hyperinflation in patients with COPD.