Atrial and Ventricular Arrhythmia-Associated Factors in Stable Patients with Chronic Obstructive Pulmonary Disease
Atrial and Ventricular Arrhythmia-Associated Factors in Stable Patients with Chronic Obstructive Pulmonary Disease
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DOI：
10.1159/000442447
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发表时间：
2016-01-01
期刊：
影响因子：
3.7
通讯作者：
Kida, Kozui
中科院分区：
文献类型：
--
作者：
Kusunoki, Yuji;Nakamura, Toshie;Kida, Kozui
背景资料：室上性和室性过早综合征（分别为SVPC和VPC）与慢性阻塞性肺病（COPD）以及COPD患者死亡率的增加有关。但关于COPD患者心律失常的病因报道较少。目的：本研究基于24小时心电图（ECG）记录，通过比较有明确心律失常（> 100次/24小时）和无心律失常的患者，探讨心肺功能障碍与COPD之间的关系。研究方法：心律失常患者接受24小时ECG和随后的肺功能检查、计算机断层扫描、ECG、6分钟步行试验（6 MWT）和BODE（体重指数、气流阻塞、改良医学研究理事会呼吸困难量表、运动能力）指数计算。结果：在103例研究患者（71例COPD患者和32例高危患者）中，36例有VPC，45例有SVPC，20例两者都有，42例两者都没有。与相应的参考组相比，SVPC和VPC组的预测的支气管扩张剂后1 s用力呼气量、计算机断层扫描上的低衰减区域比例和BODE指数值显著更差。与对照组相比，VPC组患者显示右心室压力显著增加，6 MWT中的去饱和度增加。在多变量分析中，使用支气管扩张剂是SVPC组的显著风险因素，而在VPC组中，除呼吸困难评分外的所有BODE指数参数均被确定为风险因素。结论：SVPC的增加可能是由支气管扩张剂的使用引起的，而VPC的增加可能与COPD的特殊病理生理学有关。(C)2015 S. Karger AG，巴塞尔
Background: Supraventricular and ventricular premature complexes (SVPC and VPC, respectively) are associated with chronic obstructive pulmonary disease (COPD) and with increased mortality in COPD patients. However, there are few reports on the causes of arrhythmia in COPD patients. Objectives: This study explores the associations between cardiopulmonary dysfunction and COPD by comparing patients with defined arrhythmias (> 100 beats per 24 h) and those without, based on 24-hour electrocardiogram (ECG) recordings. Methods: Patients with arrhythmia underwent a 24-hour ECG and subsequent pulmonary function tests, computed tomography, ECG, 6-min walk test (6MWT), and BODE (body mass index, airflow obstruction, modified Medical Research Council Dyspnoea Scale, exercise capacity) index calculation. Results: Of 103 study patients (71 COPD patients and 32 at-risk patients), 36 had VPC, 45 had SVPC, 20 had both, and 42 had neither. The predicted post-bronchodilator forced expiratory volume in 1 s, the proportion of low-attenuation area on computed tomography, and BODE index values were significantly worse in the SVPC and VPC groups compared with the corresponding reference groups. Patients in the VPC group showed significantly increased right ventricular pressure and increased desaturation in the 6MWT compared with the reference group. In the multivariate analyses, bronchodilator use was a significant risk factor in the SVPC group, whereas in the VPC group, all parameters of the BODE index except for the dyspnoea score were identified as risk factors. Conclusions: Increased SVPC might be caused by bronchodilator use, whereas increased VPC is likely related to the peculiar pathophysiology of COPD. (C) 2015 S. Karger AG, Basel