Comparison of cerebral blood flow in subjects with and without chronic obstructive pulmonary disease from the population-based Rotterdam Study

Sara R.A. Wijnant; Daniel Bos; Guy Brusselle; Maxim Grymonprez; Ernst Rietzschel; Meike W. Vernooij; Natalie Terzikhan; Lies Lahousse

doi:10.1136/bmjopen-2021-053671

Comparison of cerebral blood flow in subjects with and without chronic obstructive pulmonary disease from the population-based Rotterdam Study

Sara R.A. Wijnant, Daniel Bos, Guy Brusselle, Maxim Grymonprez, Ernst Rietzschel, Meike W. Vernooij, Natalie Terzikhan, Lies Lahousse^*

^*Corresponding author for this work

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Abstract

Objectives Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cerebrovascular disease, which might be associated with decreases in cerebral blood flow. Since studies examining cerebral blood flow in COPD remain scarce and are limited by sample size, we aimed to study cerebral blood flow in participants with and without COPD. Design Observational cohort study. Setting Population-based Rotterdam Study. Participants 4177 participants (age 68.0±8.5 years; 53% females) with and without COPD. Predictor variable Spirometry and pulmonary diffusing capacity. Outcome measures Cerebral blood flow by two-dimensional phase-contrast cerebral MRI. Results Compared with subjects with normal spirometry (forced expiratory volume in 1 s (FEV 1)/forced vital capacity (FVC) ≥0.7 and FEV 1 ≥80%), multivariable adjusted cerebral blood flow (mL/min) was preserved in subjects with COPD Global initiative for Chronic Obstructive Lung Disease (GOLD1) (FEV 1 /FVC <0.7 and FEV 1 ≥80%), but significantly lower in subjects with COPD GOLD2-3 (FEV 1 /FVC <0.7 and FEV 1 <80%), even after adjustment for cardiovascular comorbidities. In sex-stratified analyses, this difference in cerebral blood flow was statistically significant in women but not in men. Cerebral blood flow was lowest in subjects with FEV 1, FVC and diffusion lung capacity for carbon monoxide % predicted values in the lowest quintile, even after adjustment for cardiovascular comorbidities and cardiac function. Conclusion We observed a lowered cerebral blood flow in subjects with COPD GOLD2-3.

Original language	English
Article number	e053671
Journal	BMJ Open
Volume	11
Issue number	12
DOIs	https://doi.org/10.1136/bmjopen-2021-053671
Publication status	Published - 1 Dec 2021

Bibliographical note

Funding Information:
Funding This research was funded by the ‘Funds for Scientific Research Flanders (Fonds voor Wetenschappelijk Onderzoek Vlaanderen)’, grant number 3G037618. The Rotterdam Study is supported by the Erasmus MC and Erasmus University Rotterdam; the Netherlands Organisation for Scientific Research (NWO); the Netherlands Organisation for Health Research and Development (ZonMW); the Research Institute for Diseases in the Elderly (RIDE); the Netherlands Genomics Initiative; the Ministry of Education, Culture and Science; the Ministry of Health, Welfare and Sports; the European Commission (DG XII); and the Municipality of Rotterdam. The funding sources had no involvement in the collection, analysis, writing, interpretation, or in the decision to submit the paper for publication.

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© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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title = "Comparison of cerebral blood flow in subjects with and without chronic obstructive pulmonary disease from the population-based Rotterdam Study",

abstract = "Objectives Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cerebrovascular disease, which might be associated with decreases in cerebral blood flow. Since studies examining cerebral blood flow in COPD remain scarce and are limited by sample size, we aimed to study cerebral blood flow in participants with and without COPD. Design Observational cohort study. Setting Population-based Rotterdam Study. Participants 4177 participants (age 68.0±8.5 years; 53% females) with and without COPD. Predictor variable Spirometry and pulmonary diffusing capacity. Outcome measures Cerebral blood flow by two-dimensional phase-contrast cerebral MRI. Results Compared with subjects with normal spirometry (forced expiratory volume in 1 s (FEV 1)/forced vital capacity (FVC) ≥0.7 and FEV 1 ≥80%), multivariable adjusted cerebral blood flow (mL/min) was preserved in subjects with COPD Global initiative for Chronic Obstructive Lung Disease (GOLD1) (FEV 1 /FVC <0.7 and FEV 1 ≥80%), but significantly lower in subjects with COPD GOLD2-3 (FEV 1 /FVC <0.7 and FEV 1 <80%), even after adjustment for cardiovascular comorbidities. In sex-stratified analyses, this difference in cerebral blood flow was statistically significant in women but not in men. Cerebral blood flow was lowest in subjects with FEV 1, FVC and diffusion lung capacity for carbon monoxide % predicted values in the lowest quintile, even after adjustment for cardiovascular comorbidities and cardiac function. Conclusion We observed a lowered cerebral blood flow in subjects with COPD GOLD2-3. ",

author = "Wijnant, {Sara R.A.} and Daniel Bos and Guy Brusselle and Maxim Grymonprez and Ernst Rietzschel and Vernooij, {Meike W.} and Natalie Terzikhan and Lies Lahousse",

note = "Funding Information: Funding This research was funded by the {\textquoteleft}Funds for Scientific Research Flanders (Fonds voor Wetenschappelijk Onderzoek Vlaanderen){\textquoteright}, grant number 3G037618. The Rotterdam Study is supported by the Erasmus MC and Erasmus University Rotterdam; the Netherlands Organisation for Scientific Research (NWO); the Netherlands Organisation for Health Research and Development (ZonMW); the Research Institute for Diseases in the Elderly (RIDE); the Netherlands Genomics Initiative; the Ministry of Education, Culture and Science; the Ministry of Health, Welfare and Sports; the European Commission (DG XII); and the Municipality of Rotterdam. The funding sources had no involvement in the collection, analysis, writing, interpretation, or in the decision to submit the paper for publication. Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",

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T1 - Comparison of cerebral blood flow in subjects with and without chronic obstructive pulmonary disease from the population-based Rotterdam Study

AU - Wijnant, Sara R.A.

AU - Bos, Daniel

AU - Brusselle, Guy

AU - Grymonprez, Maxim

AU - Rietzschel, Ernst

AU - Vernooij, Meike W.

AU - Terzikhan, Natalie

AU - Lahousse, Lies

N1 - Funding Information: Funding This research was funded by the ‘Funds for Scientific Research Flanders (Fonds voor Wetenschappelijk Onderzoek Vlaanderen)’, grant number 3G037618. The Rotterdam Study is supported by the Erasmus MC and Erasmus University Rotterdam; the Netherlands Organisation for Scientific Research (NWO); the Netherlands Organisation for Health Research and Development (ZonMW); the Research Institute for Diseases in the Elderly (RIDE); the Netherlands Genomics Initiative; the Ministry of Education, Culture and Science; the Ministry of Health, Welfare and Sports; the European Commission (DG XII); and the Municipality of Rotterdam. The funding sources had no involvement in the collection, analysis, writing, interpretation, or in the decision to submit the paper for publication. Publisher Copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2021/12/1

Y1 - 2021/12/1

N2 - Objectives Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cerebrovascular disease, which might be associated with decreases in cerebral blood flow. Since studies examining cerebral blood flow in COPD remain scarce and are limited by sample size, we aimed to study cerebral blood flow in participants with and without COPD. Design Observational cohort study. Setting Population-based Rotterdam Study. Participants 4177 participants (age 68.0±8.5 years; 53% females) with and without COPD. Predictor variable Spirometry and pulmonary diffusing capacity. Outcome measures Cerebral blood flow by two-dimensional phase-contrast cerebral MRI. Results Compared with subjects with normal spirometry (forced expiratory volume in 1 s (FEV 1)/forced vital capacity (FVC) ≥0.7 and FEV 1 ≥80%), multivariable adjusted cerebral blood flow (mL/min) was preserved in subjects with COPD Global initiative for Chronic Obstructive Lung Disease (GOLD1) (FEV 1 /FVC <0.7 and FEV 1 ≥80%), but significantly lower in subjects with COPD GOLD2-3 (FEV 1 /FVC <0.7 and FEV 1 <80%), even after adjustment for cardiovascular comorbidities. In sex-stratified analyses, this difference in cerebral blood flow was statistically significant in women but not in men. Cerebral blood flow was lowest in subjects with FEV 1, FVC and diffusion lung capacity for carbon monoxide % predicted values in the lowest quintile, even after adjustment for cardiovascular comorbidities and cardiac function. Conclusion We observed a lowered cerebral blood flow in subjects with COPD GOLD2-3.

AB - Objectives Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cerebrovascular disease, which might be associated with decreases in cerebral blood flow. Since studies examining cerebral blood flow in COPD remain scarce and are limited by sample size, we aimed to study cerebral blood flow in participants with and without COPD. Design Observational cohort study. Setting Population-based Rotterdam Study. Participants 4177 participants (age 68.0±8.5 years; 53% females) with and without COPD. Predictor variable Spirometry and pulmonary diffusing capacity. Outcome measures Cerebral blood flow by two-dimensional phase-contrast cerebral MRI. Results Compared with subjects with normal spirometry (forced expiratory volume in 1 s (FEV 1)/forced vital capacity (FVC) ≥0.7 and FEV 1 ≥80%), multivariable adjusted cerebral blood flow (mL/min) was preserved in subjects with COPD Global initiative for Chronic Obstructive Lung Disease (GOLD1) (FEV 1 /FVC <0.7 and FEV 1 ≥80%), but significantly lower in subjects with COPD GOLD2-3 (FEV 1 /FVC <0.7 and FEV 1 <80%), even after adjustment for cardiovascular comorbidities. In sex-stratified analyses, this difference in cerebral blood flow was statistically significant in women but not in men. Cerebral blood flow was lowest in subjects with FEV 1, FVC and diffusion lung capacity for carbon monoxide % predicted values in the lowest quintile, even after adjustment for cardiovascular comorbidities and cardiac function. Conclusion We observed a lowered cerebral blood flow in subjects with COPD GOLD2-3.

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Comparison of cerebral blood flow in subjects with and without chronic obstructive pulmonary disease from the population-based Rotterdam Study

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