Severity of Systemic Calcified Atherosclerosis Is Associated With Airflow Limitation and Emphysema

Abstract

OBJECTIVE: We investigated the association between systemic calcified atherosclerosis and airflow limitation. METHODS: A prospective cohort of 134 patients with chronic obstructive pulmonary disease (male:female = 124:10; mean age, 65.4 years) and 101 smokers without airflow limitation (male:female = 87:14; mean age, 51.8 y) were assessed by computed tomography, pulmonary function test, and blood sampling. We measured the extent of calcification in the major thoracic arteries (thoracic aorta, coronary arteries, aortic/mitral valvular annuli, and proximal neck vessels) as indicators of systemic calcified atherosclerosis. RESULTS: After adjustment for age and smoking, total calcium score correlated with volume fraction of emphysematous lung (r = 0.19, P = 0.005) and diffusing capacity (r = - 0.15, P = 0.028). Multivariate logistic regression showed significant associations between total calcium score and forced expiratory volume at 1 second/forced vital capacity (P = 0.016) and between coronary calcium score and forced expiratory volume at 1 second/forced vital capacity (P = 0.016; P = 0.004) and diffusing capacity (P = 0.041), independent of age, body mass index, and smoking amount. CONCLUSIONS: The amount of calcification was associated with the extent of emphysema on computed tomography and airflow limitation.