IJCRR - 7(17), September, 2015
Pages: 27-33
PREVALENCE OF CARDIAC COMORBIDITIES AND ITS RELATION TO SEVERITY STAGING OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Author: Vineeth Alexander, R. Pajanivel, K. Surendra Menon, Arun Prasath
Category: Healthcare
[Download PDF]
Abstract:
Background: Complexity of COPD and mortality from the disease is increased by co morbidities and exacerbations
Objective: This study was conducted with aim to find the prevalence of cardiac co morbidity in COPD and its relation to severity staging of COPD.
Methods: The present cross sectional study was done in Pulmonary Medicine outpatient department of Mahatma Gandhi Medical College and Research Institute, Pondicherry from March 2013 to June 2014. The study diagnosed and newly diagnosed of COPD patients were subjected to Pulmonary Function Test (PFT), assessment of blood pressure, electrocardiography and echocardiography. The statistical analysis was done to assess the cardiovascular status of the study subjects and its relation to severity staging of COPD.
Results: In the total of 44 cases selected for study 42 (95.5%) were males and 2(4.5%) were females. On the basis of GOLD guidelines there were 5(11.4%), 13(29.5%), 16(36.4%) and 10(22.7%) mild, moderate, severe, and very severe COPD respectively. Right axis deviation, p-pulmonale, T-wave inversions, dominant R-wave, persistent S-wave in electrocardiography were present in 45.5%,52.6%,40.0%,33.3%,36.4% of severe and 54.5%, 36.8%, 60.0%, 58.3%, 63.6% in very severe cases of COPD. In echocardiography, right atrium and ventricle dilatation, left ventricular dysfunction, tricuspid regurgitation, and regional wall
motion abnormalities were present in 55.6%, 46.15%, 50.0%, 37.5% of severe and 38.9%, 53.85%, 33.3%, 62.5% of very severe cases of COPD. Pulmonary artery systolic pressure and systemic hypertension increased with severity of COPD.
Conclusion: Prevalence of cardiac co morbidities increases with the increase in severity of COPD. The severe and very severe stages of COPD are associated with significant cardiovascular diseases.
Keywords: COPD, Electrocardiography, Echocardiography, Pulmonary artery systolic pressure
Citation:
Vineeth Alexander, R. Pajanivel, K. Surendra Menon, Arun Prasath. PREVALENCE OF CARDIAC COMORBIDITIES AND ITS RELATION TO SEVERITY STAGING OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE International Journal of Current Research and Review. 7(17), September, 27-33
References:
1. Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS (2001) GOLD Scientific Committee. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Resp Crit Care Med 163:1256 – 1276.
2. Calverley PM, Walker P. Chronic obstructive pulmonary disease. Lancet 2003; 362: 1053–1061.
3. Sullivan SD, Ramsey SD, Lee TA. The economic burden of COPD. Chest 2000; 117: 5S–9S.
4. Ferrer M, Alonso J, Morera J, et al. Chronic obstructive pulmonary disease stage and health-related quality of life. Ann Intern Med 1997; 127: 1072–1079.
5. Lopez AD, Shibuya K, Rao C, et al. Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J 2006;27:397-412.
6. Snider GL. Nosology for our day: its application to chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2003; 167: 678–683.
7. Laurell CB, Eriksson S. The electrophoretic alpha-1 globulin pattern of serum in alpha-1 antitrypsin deficiency. Scand J Clin Lab Invest 1963;15:132–140.
8. Hubbard RC, Crystal RG. Antiproteases. In: RB Crystal, JB West, PJ Barnes, NS Cherniack, ER Weibel, editors. The lung: scientific foun- dations. New York: Raven Press; 1991. p. 1775– 1787.
9. McElvaney NG, Crystal RG. Inherited susceptibility of the lung to pro- teolytic injury. In: RG Crystal, JB West, ER Weibel, PJ Barnes, edi- tors. The Lung: Scientific Foundations, 2nd ed. Philadelphia: Lippin- cott-Raven; 1997. p. 2537–2553.
10. Prescott E, Lange P, Vestbo J. Socioeconomic status, lung function and admission to hospital for COPD: results from the Copenhagen City Heart Study. Eur Respir J 1999;13:1109–1114.
11. GOLD - the Global initiative for chronic Obstructive Lung Disease [updated 2013 Feb 1; accessed 2013 Jun 20]. Available from: http://www. goldcopd.org/guidelines-global-strategy-fordiagnosis-management.html.
12. Mannino DM, Thorn D, Swensen A, Holguin F. Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD. Eur Respir J 2008;32:962–969.
13. Soler-Catalun ?a JJ, Martínez-García MA, Román Sánchez P, Salcedo E, Navarro M, Ochando R. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax 2005;60: 925–931.
14. Sevenoaks MJ, Stockley RA. Chronic obstructive pul- monary disease, inflammation and co-morbidity – a common inflammatory phenotype? Respir Res 2006; 7: 70.
15. Nussbaumer-Ochner Y, Rabe KF. Systemic manifestations of COPD. Chest. 2011;139:165---73.
16. Chatila WM, Thomashow BM, Minai OA, Criner GJ, Make BJ. Comorbidities in chronic obstructive pulmonary disease. Proc Am Thorac Soc. 2008;5:549---55.
17. Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD. Eur Respir J. 2009;33:1165---85.
18. Fabbri LM, Rabe KF. From COPD to chronic systemic inflammatory syndrome? Lancet 2007; 370: 797–799.
19. Raherison C, Girodet PO. Epidemiology of COPD. Eur Respir Rev. 2009;18:213---21.
20. McGarvey LP, John M, Anderson JA, Zvarich M, Wise RA. Ascer- tainment of cause-specific mortality in COPD: operations of the TORCH Clinical Endpoint Committee. Thorax. 2007;62:411---5.
21. Anthonisen NR, Skeans MA, Wise RA, Manfreda J, Kanner RE, Connett JE. The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial. Ann Intern Med. 2005;142:233---9.
22. Sin DD, Anthonisen NR, Soriano JB, Agusti AG. Mortality in COPD: role of comorbidities. Eur Respir J. 2006;28:1245---57.
23. Soriano JB, V isick GT, Muellerova H, Payvandi N, Hansell AL. Patterns of comorbidities in newly diagnosed COPD and asthma in primary care. Chest 2005;128:2099-107.
24. Fabbri LM, Luppi F , Beghe B, Rabe KF. Complex chronic comorbidities of COPD. Eur Respir J 2008;31:204-12.
25. Hansell AL, Walk JA, Soriano JB. What do chronic obstructive pulmonary disease patients die from? A multiple cause coding analysis. Eur Respir J. 2003;22:809-14.
26. Huiart L, Erns P, Suissa S. Cardiovascular morbidity and mortality in COPD. Chest. 2005;128:2640-6.
27. Hole J, Watt GC, Davey-Smith, Hart CL, Gillis CR, Hawthorne VM. Impaired lung function and mortality risk in men and women: findings from the Renfrew and Paisley prospective population study. BMJ. 1996;313:711-5.
28. Rappaport E. Cor pulmonale. In: Murray JJ, Nadel JA, Mason RM, Boushey H, editors. Textbook of respiratory medicine. 4th Edition. Philadelphia: W.B. Saunders; 2000. pp. 1631–48.
29. Dankner R, Goldbourt U, Boyko V, et al. Predictors of cardiac and noncardiac mortality among 14,097 patients with coronary heart disease: BIP Study Group. Am J Cardiol 2003; 91:121- 127.
30. Behar S, Panosh A, Reicher-Reiss H, et al. Prevalence and prognosis of chronic obstructive pulmonary disease among 5,839 consecutive patients with acute myocardial infarction: SPRINT Study Group. Am J Med 1992; 93:637-64.
31. Samuels LE, Kaufman MS, Morris RJ, et al. Coronary artery bypass grafting in patients with COPD. Chest 1998; 113:878-882.
32. Agustí A , Edwards LD , Rennard SI , et al ; Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) Investigators . Persistent systemic infl ammation is associated with poor clinical outcomes in COPD: a novel phenotype . PLoS ONE . 2012 ; 7 ( 5 ): e37483 .
33. Agustí AG , Noguera A , Sauleda J , Sala E , Pons J , Busquets X . Systemic effects of chronic obstructive pulmonary disease . Eur Respir J . 2003 ; 21 ( 2 ): 347 - 360 .
34. Gan WQ , Man SF , Senthilselvan A , Sin DD . Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis .Thorax2004 ; 59 ( 7 ): 574 - 580.
35. MacNee W . Pulmonary and systemic oxidant/antioxidant imbalance in chronic obstructive pulmonary disease . Proc Am Thorac Soc. 2005 ;2( 1 ):50 - 60 .
36. Garcia-Aymerich J , Lange P , Benet M , Schnohr P , Antó JM . Regular physical activity modifi es smoking-related lung function decline and reduces risk of chronic obstructive pulmonary disease: a population-based cohort study . Am J Respir Crit Care Med. 2007 ; 175 (5): 458 - 463.
37. Padmavati S, Raizada V. Electrocardiogram in chronic cor pul-monale. Br Heart J. 1972 Jul;34(7):658–667.
38. Holtzman D, Aronow WS, Mellana WM, Sharma M, Mehta N, Lim J, et al. Electrocardiographic abnormalities in patients with severe versus mild or moderate chronic obstructive pulmonary disease followed in an academic outpatient pulmonary clinic. Ann Noninvasive Electrocardiol Off J Int Soc Holter Noninvasive Electrocardiol Inc. 2011 Jan;16(1):30–2.
39. Spodick DH, Hauger - Kelvene JH, Tyler JM, Muesch H, Dorr CA. The electrocardiogram in pulmonary emphysema. Relationship of characteristic electrocardiographic findings to severity of disease as measured by degree of airway obstruction. Am Rev Resp Dis 1963; 88:14.
40. Carid FI and Wilcken DEL. ECG in chronic bronchitis with generalised obstructive lung diseases - Its relation to ventilatory junction. Am J Card 1962; 10:5.
41. Scott RC, Kaplan S, Fowler O, Helm RA, Westcott RN, Walker IC et al. The electrocardiographic pattern of right ventricular hypertrophy in chronic corpulmonale Circulation 1955; 11:927. 42. Pinto, Hansoti RC. The ECG changes in chronic corpulmonale. J Assoc Phy India 1960; 8:213.
43. Agarwal, R; Kumar, Dinesh; Gurpreet; Agarwal, D; Chabra, G.Diagnostic values of electrocardiogram in chronic obstructive pulmonary disease (COPD) Lung India25.2 (Apr 2008): 78-81.
44. Higham MA, Dawson D, Joshi J, Nihoyannopoulos P, Morrell NW. Utility of echocardiography in assessment of pulmonary hypertension secondary to COPD. Eur Respir J. 2001;17:350–5.
45. Ahmed AH, Yagoub TE, Muthana F. Prevalence of chronic obstructive pulmonary disease in patients with catheter-diagnosed coronary artery disease. Ann Thorac Med. 2009 Apr;4(2):91–2.
46. Reed RM, Eberlein M, Girgis RE, Hashmi S, Iacono A, Jones S, et al. Coronary artery disease is under-diagnosed and under-treated in advanced lung disease. Am J Med. 2012 Dec;125(12):1228. e13–1228.e22.
47. Weitzenblum E, Hirth C, Ducolone A, Mirhom R, Rasaholinjanahary J, Ehrhart M. Prognostic value of pulmonary artery pressure In chronic COPD. Thorax. 1981;36:752–8.
48. Burrows B, Kettel LJ, Niden AH, Rabinowitz M, Diener CF. Patterns of cardiovascular dysfunction in COPD. N Engl J Med. 1972;286:912–8.
49. Fishman AP. State of the art: Chronic cor pulmonale. Am Rev Respir Dis. 1976;114:775–94.
50. Thabut G, Dauriat G, Stern JB, Logeart D, Lévy A, MarrashChahla R, et al. Pulmonary haemodynamics in advanced COPD candidates for lung volume reduction surgery or lung transplantation. Chest. 2005;127:1531–6.
51. Springhouse. Respiratory disorders. In, Springhouse (ed). Professional Guide to Diseases.9th Edition. Philadelphia, Lippincott William and Wilkins 2008;120.
52. Rigolin VH, Robiolio PA, Wilson JS, Harrison JK, Bashore TM. The forgotten chamber: The importance of the right ventricle. Cathet Cardiovasc Diagn 1995;35:18-28.
53. Engström G, Hedblad B, Valind S, Janzon L. Increased incidence of myocardial infarction and stroke in hypertensive men with reduced lung function. J Hyperten 2001;19:295-301.
|