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Titel: Effects of airway obstruction and hyperinflation on electrocardiographic axes in COPD
VerfasserIn: Alter, Peter
Watz, Henrik
Kahnert, Kathrin
Rabe, Klaus F.
Biertz, Frank
Fischer, Ronald
Jung, Philip
Graf, Jana
Bals, Robert
Vogelmeier, Claus F.
Jörres, Rudolf A.
Sprache: Englisch
Titel: Respiratory Research
Bandnummer: 20
Heft: 1
Verlag/Plattform: BMC
Erscheinungsjahr: 2019
Freie Schlagwörter: COPD
Airway obstruction
Hyperinflation
Electrocardiographic axis
P wave axis
QRS axis
T wave axis
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Background: COPD influences cardiac function and morphology. Changes of the electrical heart axes have been largely attributed to a supposed increased right heart load in the past, whereas a potential involvement of the left heart has not been sufficiently addressed. It is not known to which extent these alterations are due to changes in lung function parameters. We therefore quantified the relationship between airway obstruction, lung hyperinflation, several echo- and electrocardiographic parameters on the orientation of the electrocardiographic (ECG) P, QRS and T wave axis in COPD. Methods: Data from the COPD cohort COSYCONET were analyzed, using forced expiratory volume in 1 s (FEV1), functional residual capacity (FRC), left ventricular (LV) mass, and ECG data. Results: One thousand, one hundred and ninety-five patients fulfilled the inclusion criteria (mean ± SD age: 63.9 ± 8.4 years; GOLD 0–4: 175/107/468/363/82). Left ventricular (LV) mass decreased from GOLD grades 1–4 (p = 0.002), whereas no differences in right ventricular wall thickness were observed. All three ECG axes were significantly associated with FEV1 and FRC. The QRS axes according to GOLD grades 0–4 were (mean ± SD): 26.2° ± 37.5°, 27.0° ± 37.7°, 31.7° ± 42.5°, 46.6° ± 42.2°, 47.4° ± 49.4°. Effects of lung function resulted in a clockwise rotation of the axes by 25°-30° in COPD with severe airway disease. There were additional associations with BMI, diastolic blood pressure, RR interval, QT duration and LV mass. Conclusion: Significant clockwise rotations of the electrical axes as a function of airway obstruction and lung hyperinflation were shown. The changes are likely to result from both a change of the anatomical orientation of the heart within the thoracic cavity and a reduced LV mass in COPD. The influences on the electrical axes reach an extent that could bias the ECG interpretation. The magnitude of lung function impairment should be taken into account to uncover other cardiac disease and to prevent misdiagnosis.
DOI der Erstveröffentlichung: 10.1186/s12931-019-1025-y
URL der Erstveröffentlichung: https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-019-1025-y
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-366734
hdl:20.500.11880/33318
http://dx.doi.org/10.22028/D291-36673
ISSN: 1465-993X
Datum des Eintrags: 7-Jul-2022
Bezeichnung des in Beziehung stehenden Objekts: Additional files
In Beziehung stehendes Objekt: https://static-content.springer.com/esm/art%3A10.1186%2Fs12931-019-1025-y/MediaObjects/12931_2019_1025_MOESM1_ESM.docx
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Innere Medizin
Professur: M - Prof. Dr. Robert Bals
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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