Metal Homeostasis Imbalance as Potentially Contributing Mechanism in Onset of Cardiac Disorders in Individuals with Chronic Obstructive Pulmonary Disease and Chronic Kidney Disease.

Abstract

Chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD) are common non-communicable diseases associated with disturbances in metal and metalloid homeostasis and an increased risk of cardiovascular disorders. However, the mechanisms underlying these associations remain incompletely understood. Therefore, this study investigated whether COPD or CKD is associated with altered accumulation of selected metals and metalloids in the left ventricular myocardium. We analyzed 57 autopsy-derived left ventricular myocardial specimens, including 12 individuals with COPD, 11 with CKD, and 34 controls (mean age 70 ± 14 years). Concentrations of arsenic, lead, calcium, cadmium, mercury, manganese, magnesium, iron, copper, nickel, and zinc were determined using inductively coupled plasma mass spectrometry (ICP-MS). Individuals with COPD had significantly higher myocardial cadmium concentrations, whereas individuals with CKD exhibited lower myocardial iron concentrations in unadjusted analyses. Zn levels and Zn/Cu and Zn/Fe ratios were inversely correlated with Pb, As, and Hg. After adjustment for the presence of cardiomyopathy, myocardial cadmium concentrations remained significantly higher, while magnesium concentrations were significantly lower in individuals with COPD compared with controls. No significant differences remained between individuals with CKD and controls. Higher myocardial cadmium and lower magnesium concentrations in individuals with COPD suggest altered myocardial metal homeostasis that may be relevant to COPD-associated cardiac alterations. Further studies are needed to clarify the mechanisms and clinical significance of these findings.