Please use this identifier to cite or link to this item: doi:10.22028/D291-36663
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Title: Airway obstruction and lung hyperinflation in COPD are linked to an impaired left ventricular diastolic filling
Author(s): Alter, Peter
Watz, Henrik
Kahnert, Kathrin
Pfeifer, Michael
Randerath, Winfried J.
Andreas, Stefan
Waschki, Benjamin
Kleibrink, Björn E.
Welte, Tobias
Bals, Robert
Schulz, Holger
Biertz, Frank
Young, David
Vogelmeier, Claus F.
Jörres, Rudolf A.
Language: English
Title: Respiratory Medicine
Volume: 137
Pages: 14-22
Publisher/Platform: Elsevier
Year of Publication: 2018
Free key words: COPD
Airway obstruction
Hyperinflation
Diastolic filling
Dyspnea
Heart failure
HFpEF
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Aims Chronic obstructive pulmonary disease (COPD) and cardiovascular diseases are thought to be linked through various factors. We aimed to assess the relationship between airway obstruction, lung hyperinflation and diastolic filling in COPD. Methods The study population was a subset of the COPD cohort COSYCONET. Echocardiographic parameters included the left atrial diameter (LA), early (E) and late (A) transmitral flow, mitral annulus velocity (e’), E wave deceleration time (E[dt]), and isovolumic relaxation time (IVRT). We quantified the effect of various predictors including forced expiratory volume in 1 s (FEV1) and intrathoracic gas volume (ITGV) on the echocardiographic parameters by multiple linear regression and integrated the relationships into a path analysis model. Results A total of 615 COPD patients were included (mean FEV1 52.6% predicted). In addition to influences of age, BMI and blood pressure, ITGV was positively related to e’-septal and negatively to LA, FEV1 positively to E(dt) (p < 0.05 each). The effect of predictors was most pronounced for LA, e’-septal and E(dt), and less for E/A, IVRT and E/e’. Path analysis was used to take into account the additional relationships between the echocardiographic parameters themselves, demonstrating that their associations with the predictors were maintained and robust. Conclusions Airway obstruction and lung hyperinflation were significantly associated with cardiac diastolic filling in patients with COPD, suggesting a decreased preload rather than an inherently impaired myocardial relaxation itself. This suggests that a reduction in obstruction and hyperinflation could help to improve cardiac filling.
DOI of the first publication: 10.1016/j.rmed.2018.02.011
URL of the first publication: https://www.sciencedirect.com/science/article/pii/S0954611118300404
Link to this record: urn:nbn:de:bsz:291--ds-366632
hdl:20.500.11880/33303
http://dx.doi.org/10.22028/D291-36663
ISSN: 0954-6111
Date of registration: 6-Jul-2022
Faculty: M - Medizinische Fakultät
Department: M - Innere Medizin
Professorship: M - Prof. Dr. Robert Bals
Collections:Die Universitätsbibliographie

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