Left ventricular volume and wall stress are linked to lung function impairment in COPD

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:261

Article

Alter, Peter¹  Joerres, Rudolf A.²  Watz, Henrik³  Welte, Tobias⁴  Glaeser, Sven⁵  Schulz, Holger⁶  Bals, Robert⁷  Karch, Annika⁸  Wouters, Emiel F. M.⁹  Vestbo, Jorgen¹⁰  Young, David¹¹  Vogelmeier, Claus F.¹ 

[1] Philipps Univ Marburg, Dept Med Pulm & Crit Care Med, German Ctr Lung Res DZL, Marburg, Germany

[2] Ludwig Maximilians Univ Munchen, CPC M, Inst & Outpatient Clin Occupat Social & Environm, German Ctr Lung Res DZL, Munich, Germany

[3] Lungen Clin Grosshansdorf, ARCN, Pulm Res Inst, German Ctr Lung Res DZL, Grosshansdorf, Germany

[4] Hannover Med Sch, German Ctr Lung Res DZL, Clin Pneumol, Hannover, Germany

[5] Ernst Moritz Arndt Univ Greifswald, Dept Pneumol, Greifswald, Germany

[6] Helmholtz Ctr Munich, Inst Epidemiol, German Res Ctr Environm Hlth, CPC M,German Ctr Lung Res DZL, Munich, Germany

[7] Saarland Univ Hosp, Dept Internal Med Pulmonol Allergol Intens Care M, Intens Care Med, Saarland, Germany

[8] Hannover Med Sch, Inst Biostat, Ctr Biometry Med Informat & Med Technol, Hannover, Germany

[9] Maastricht Univ, Dept Resp Med, Med Ctr, Maastricht, Netherlands

[10] Univ Manchester, Div Infect Immun & Resp Med, Manchester, Lancs, England

[11] Young Med Commun & Consulting Ltd, Horsham, W Sussex, England

关键词: COPD;    Airflow limitation;    Hyperinflation;    Heart failure;    Ventricular wall stress;    Dyspnea;    Breathing;   

DOI  :  10.1016/j.ijcard.2018.02.074

来源: Elsevier

【 摘 要 】

Background: Cardiovascular comorbidities are common in chronic obstructive pulmonary disease (COPD). We examined the association between airflow limitation, hyperinflation and the left ventricle (LV). Methods: Patients from the COPD cohort COSYCONET underwent evaluations including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), effective airway resistance (Reff), intrathoracic gas volume (ITGV), and echocardiographic LV end-diastolic volume (LVEDV), stroke volume (LVSV), end-systolic volume (LVESV), and end-diastolic and end-systolic LV wall stress. Data from Visit 1 (baseline) and Visit 3 (18 months later) were used. In addition to comparisons of both visits, multivariate regression analysis was conducted, followed by structural equation modelling (SEM) with latent variables Lung' and Left heart. Results: A total of 641 participants were included in this analysis. From Visit 1 to Visit 3, there were significant declines in FEV1 and FEV1/FVC, and increases in R-eff, ITGV and LV end-diastolic wall stress, and a borderline significant decrease in LV mass. There were significant correlations of: FEV1 predicted with LVEDV and LVSV; R-eff (with LVSV; and ITGV with LV mass and LV end-diastolic wall stress. The SEM fitted the data of both visits well (comparative fit index: 0.978, 0.962), with strong correlation between Lung and Left heart. Conclusions: We demonstrated a relationship between lung function impairment and LV wall stress in patients with COPD. This supports the hypothesis that LV impairment in COPD could be initiated or promoted, at least partly, by mechanical factors exerted by the lung disorder. (C) 2018 Elsevier B.V. All rights reserved.

【 授权许可】

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