United in prevention-electrocardiographic screening for chronic obstructive pulmonary disease

Identification of electrocardiographic values that indicate chronic obstructive pulmonary disease

BACKGROUND

The purpose of this study was to investigate the association between respiratory function and electrocardiogram (ECG) characteristics in patients with chronic obstructive pulmonary disease (COPD), and to identify the ECG results that indicate possible COPD.

METHODS

The association between respiratory function and ECG results was retrospectively analyzed in 45 patients with COPD and 100 patients without COPD (controls).

RESULTS

Multiple logistic regression analysis revealed that QRS amplitude in lead І was a significant predictor of COPD (partial regression coefficient = -4.208, p = 0.002). Receiver operating characteristic curve analysis showed that a QRS amplitude less than 0.54 mV in lead І indicated possible COPD (sensitivity: 71%, specificity: 76%, area under the curve: 0.78 [95% confidence interval: 0.69-0.86], p < 0.001).

CONCLUSION

Low voltage in lead І (QRS less than 0.54 mV) is an important criterion in detecting COPD.

Czech multicenter research database of severe COPD

Purpose

Chronic obstructive pulmonary disease (COPD) has been recognized as a heterogeneous, multiple organ system-affecting disorder. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) places emphasis on symptom and exacerbation management. The aim of this study is examine the course of COPD and its impact on morbidity and all-cause mortality of patients, with respect to individual phenotypes and GOLD categories. This study will also evaluate COPD real-life patient care in the Czech Republic.

Patients and methods

The Czech Multicentre Research Database of COPD is projected to last for 5 years, with the aim of enrolling 1,000 patients. This is a multicenter, observational, and prospective study of patients with severe COPD (post-bronchodilator forced expiratory volume in 1 second ≤60%). Every consecutive patient, who fulfils the inclusion criteria, is asked to participate in the study. Patient recruitment is done on the basis of signed informed consent. The study was approved by the Multicentre Ethical Committee in Brno, Czech Republic.

Results

The objective of this paper was to outline the methodology of this study.

Conclusion

The establishment of the database is a useful step in improving care for COPD subjects. Additionally, it will serve as a source of data elucidating the natural course of COPD, comorbidities, and overall impact on the patients. Moreover, it will provide information on the diverse course of the COPD syndrome in the Czech Republic.

Acute exacerbation of chronic obstructive pulmonary disease: cardiovascular links

Chronic obstructive pulmonary disease (COPD) is a chronic, progressive lung disease resulting from exposure to cigarette smoke, noxious gases, particulate matter, and air pollutants. COPD is exacerbated by acute inflammatory insults such as lung infections (viral and bacterial) and air pollutants which further accelerate the steady decline in lung function. The chronic inflammatory process in the lung contributes to the extrapulmonary manifestations of COPD which are predominantly cardiovascular in nature. Here we review the significant burden of cardiovascular disease in COPD and discuss the clinical and pathological links between acute exacerbations of COPD and cardiovascular disease.

Diagnostic electrocardiographic dyad criteria of emphysema in left ventricular hypertrophy

BACKGROUND

The electrocardiographic diagnostic dyad of emphysema, namely a combination of the frontal vertical P-vector and a narrow QRS duration, can serve as a quasidiagnostic marker for emphysema, with specificity close to 100%. We postulated that the presence of left ventricular hypertrophy in emphysema may affect the sensitivity of this electrocardiographic criterion given that left ventricular hypertrophy generates prominent left ventricular forces and may increase the QRS duration.

METHODS

We reviewed the electrocardiograms and echocardiograms for 73 patients with emphysema. The patients were divided into two groups based on the presence or absence of echocardiographic evidence of left ventricular hypertrophy. The P-vector, QRS duration, and forced expiratory volume in one second (FEV1) were computed and compared between the two subgroups.

RESULTS

There was no statistically significant difference in qualitative lung function (FEV1) between the subgroups. There was no statistically significant difference in mean P-vector between the subgroups. The mean QRS duration was significantly longer in patients with left ventricular hypertrophy as compared with those without left ventricular hypertrophy.

CONCLUSION

The presence of left ventricular hypertrophy may not affect the sensitivity of the P-vector verticalization when used as a lone criterion for diagnosing emphysema. However, the presence of left ventricular hypertrophy may significantly reduce the sensitivity of the electrocardiographic diagnostic dyad in emphysema, as it causes a widening of the QRS duration.