Please use this identifier to cite or link to this item: doi:10.22028/D291-37471
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Title: Prevalence of cardiac comorbidities, and their underdetection and contribution to exertional symptoms in COPD : results from the COSYCONET cohort
Author(s): Alter, Peter
Mayerhofer, Barbara A.
Kahnert, Kathrin
Watz, Henrik
Waschki, Benjamin
Andreas, Stefan
Biertz, Frank
Bals, Robert
Vogelmeier, Claus F.
Jörres, Rudolf A.
Language: English
Title: International Journal of Chronic Obstructive Pulmonary Disease
Volume: 2019
Issue: 14
Pages: 2163-2172
Publisher/Platform: DOVE
Year of Publication: 2019
Free key words: COPD
heart failure
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Background: A substantial prevalence of cardiovascular disease is known for COPD, but detection of its presence, relationship to functional findings and contribution to symptoms remains challenging. The present analysis focusses on the cardiovascular contribution to COPD symptoms and their relationship to the patients’ diagnostic status, medication and echocardiographic findings. Methods: Patients from the COPD cohort COSYCONET with data on lung function, including FEV1, residual volume/total lung capacity (RV/TLC) ratio, diffusing capacity TLCO, and echocardiographic data on left ventricular ejection fraction (LVEF) and enddiastolic diameter (LVEDD), medical history, medication, modified British Medical Research Council dyspnea scale (mMRC) and Saint Georges Respiratory Questionnaire (SGRQ) were analyzed. Results: A total of 1591 patients (GOLD 0–4: n=230/126/614/498/123) fulfilled the inclusion criteria. Ischemic heart disease, myocardial infarction or heart failure were reported in 289 patients (18.2%); 860 patients (54%) received at least one cardiovascular medication, with more than one in many patients. LVEF<50% or LVEDD>56 mm was found in 204 patients (12.8%), of whom 74 (36.3%) had neither a cardiovascular history nor medication. Among 948 patients (59.6%) without isolated hypertension, there were 21/55 (38.2%) patients with LVEF<50% and 47/88 (53.4%) with LVEDD>56 mm, who lacked both a cardiac diagnosis and medication. LVEDD and LVEF were linked to medical history; LVEDD was dependent on RV/TLC and LVEF on FEV1. Exertional COPD symptoms were best described by mMRC and the SGRQ activity score. Beyond lung function, an independent link from LVEDD on symptoms was revealed. Conclusion: A remarkable proportion of patients with suspicious echocardiographic findings were undiagnosed and untreated, implying an increased risk for an unfavorable prognosis. Cardiac size and function were dependent on lung function and only partially linked to cardiovascular history. Although the contribution of LV size to COPD symptoms was small compared to lung function, it was detectable irrespective of all other influencing factors. However, only the mMRC and SGRQ activity component were found to be suitable for this purpose.
DOI of the first publication: 10.2147/COPD.S209343
URL of the first publication:
Link to this record: urn:nbn:de:bsz:291--ds-374715
ISSN: 1178-2005
Date of registration: 30-Sep-2022
Faculty: M - Medizinische Fakultät
Department: M - Innere Medizin
Professorship: M - Prof. Dr. Robert Bals
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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