A correlation between severity of chronic obstructive pulmonary disorders, electrocardiography and echocardiography of patients: a prospective observational study
Keywords:Chronic obstructive pulmonary disease, Cardiovascular changes, Electrocardiography and echocardiography
Background: Chronic obstructive pulmonary disease (COPD) is defined as a disease state characterised by persistent respiratory symptom and airflow limitation which is not fully reversible. It has been reported that patient with COPD has higher mortality due to cardiac disorder. We have designed this study with an aim to evaluate electrocardiography and echocardiography changes in COPD patients and correlate this finding with severity of disease.
Method: In present study 60 randomly selected COPD patients were evaluated clinically, echocardiographically, electrocardiographically and pulmonary function test was performed. A careful history of patient was taken regarding demography, symptoms and aggravation factors. Detailed clinical examination of patient was done to know the sign symptom of cardiological and respiratory involvement.
Result: In patients with severe COPD 4 (20%) patients have normal ECG, 12 (60%) have P pulmonale, 14 (70%) patients have right ventricular hypertrophy, low voltage complex was found in 6 (30%), RBBB was present in 4 (20%) patients, 12 (60%) have r wave in their electrocardiograph (ECG) and 2 (10%) patients presented with arrhythmia.
Conclusions: From our study we can conclude that most of the patients with COPD were in 5th and 6th decade of life with male predominance. Patients with moderate airflow obstruction were common than severe obstruction. Cardiovascular changes depend upon the severity of disease.
Silverman EK, Capreo JD, Barry J. Make Chronic obstructive pulmonary disease, Harrisons principal of internal medicine, Mc Graw Hill publication, 20th edition. 2018;286:1990.
Global strategy for prevention, diagnosis and management of COPD, global initiative for chronic obstructive pulmonary disease gold 2020.downloaded from https://goldcopd.org/wp-content/uploads/2020/03/gold-2020-pocket-guide-ver1.0_final-wmv.pdf. Accessed on 12 June 2020.
Fact sheet 2017, World health organisation. Available from https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd). Accessed on 12 June 2020.
Morgan AD, Zakeri R, Quint JK. Defining the relationship between COPD and CVD: what are the implications for clinical practice? Ther Adv Respir Dis. 2018;12:1753465817750524.
Decramer M, Janssens W. Chronic obstructive pulmonary disease and comorbidities. Lancet Respir Med. 2013;1:73-83.
Berry CE, Wise RA. Mortality in COPD: causes, risk factors, and prevention. COPD. 2010;7:375-82.
Maclay JD, MacNee W. Cardiovascular disease in COPD: mechanisms. Chest. 2013;143:798-807.
Andréa SB, Condeb E, Fragosoc JP, Boléo-Toméd V, Areiasef J. Cardosogh COPD and Cardiovascular Disease. Pulmonol. 2016;25(3):168-76.
Sin DD, Man SF. Impact of cancers and cardiovascular disease in chronic obstructive pulmonary disease. Curr Opin Pulm Med. 2008;14(2):115-21.
die from?A multiple cause coding analysis. Eur Respir J 2003; 22:809–814.
Chronic obstructive pulmonary disease in over 16s: diagnosis and management, Available from https://www.nice.org.uk/guidance/ng115/chapter/recommendations#diagnosing-copd. Accessed on 12 June 2020.
Hunninghake DB, Cardiovascular disease in chronic obstructive pulmonary disease. Proc Am Thorac Soc. 2005;2(1):44-9.
Divo M, Cote C, de Torres JP, Casanova C, Marin JM, Pinto-Plata V et al. Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2012;186:155-61.
Postma DS, Siafakas N. Epidemiology of chronic obstructive pulmonary disease. In Management of Chronic Obstructive Pulmonary Disease. Eur Respir Mon. 1998;7:41-73.
Mannino DM, Buist AS. Global burden of COPD: risk factors, prevalence, and future trends. Lancet. 2007;370:765-73.
Prescott E, Bjerg AM, Andersen PK, Lange P, Vestbo J. Gender difference in smoking effects on lung function and risk of hospitalization for COPD: results from a Danish longitudinal population study. Eur Respir J. 1997;10:822-7.
Jatav VS, Meena SR, Jelia S, Jain P, Ajmera D, Agarwal V et al. Echocardiographic findings in chronic obstructive pulmonary disease and correlation of right ventricular dysfunction with disease severity. Int J Adv Med. 2017;4:476-80.
Chaudhari R, Shrimali L. Study of clinical, electrocardiographic and echocardiographic profile in patients with chronic obstructive pulmonary disease. Int J Res Med Sci. 2018;6:1716-20.
Gupta NK, Agrawal RK, Srivastav AB, Ved ML. Echocardiographic evaluation of heart in chronic obstructive pulmonary disease patient and its co-relation with the severity of disease. Lung India. 2011;28(2):105-109.
Scott RC. The electrocardiogram in pulmonary emphysema and chronic corpulmonale. Amer Heart J. 1961;61:843.
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.
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.
Buklioska-Ilievska D, Minov J, Kochovska-Kamchevska N. Cardiovascular Comorbidity in Patients with Chronic Obstructive Pulmonary Disease: Echocardiography Changes and Their Relation to the Level of Airflow Limitation. Maced J Med Sci. 2019;7(21):3568-73.
Freixa X, Portillo K, Paré C, Garcia-Aymerich J, Gomez FP, Benet M. Echocardiographic abnormalities in patients with COPD at their first hospital admission. Eur Respiratory J. 2013;41:784-91.