Endothelial function in patients with COPD and cardiovascular disease (review)

Abstract

Cardiovascular pathology is one of the frequent comorbidities in patients with chronic obstructive pulmonary disease, due to both genetic predisposition and common risk factors (smoking, senile age, male gender, sedentary lifestyle, obesity). The article shows that development of endothelial dysfunction is one of the earliest phases of pathogenesis in this setting. Endothelial dysfunction mechanisms are defined and characterized, including imbalance of vasoconstricting and vasodilating agents with the emergence of "vicious circles" that violate hematovascular homeostasis. The role of nitric oxide, endothelin-1, intercellular adhesion molecule-1 (ICAM-1) in the development of endothelial dysfunction in COPD patients is discussed. The article defines the concept of oxidative stress, the most potent oxidants and mechanisms of their damaging effect are listed. A particular attention is paid to 8-isoprostane as a golden standard in assessment of oxidative stress in patients with COPD. Keywords: chronic obstructive pulmonary disease, hypertension, coronary artery disease, heart failure, nitric oxide, endothelin-1, intercellular adhesion molecule-1, 8-isoprostane.