Universität zu Köln

Alter, Peter ORCID: 0000-0002-2115-1743, Watz, Henrik, Kahnert, Kathrin, Pfeifer, Michael, Randerath, Winfried J., Andreas, Stefan, Waschki, Benjamin ORCID: 0000-0002-1070-3661, Kleibrink, Bjorn E., Welte, Tobias, Bals, Robert, Schulz, Holger, Biertz, Frank, Young, David, Vogelmeier, Claus F. and Jorres, Rudolf A. (2018). Airway obstruction and lung hyperinflation in COPD are linked to an impaired left ventricular diastolic filling. Respir. Med., 137. S. 14 - 23. LONDON: W B SAUNDERS CO LTD. ISSN 1532-3064

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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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Alter, Peter UNSPECIFIED orcid.org/0000-0002-2115-1743 UNSPECIFIED Watz, Henrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Kahnert, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfeifer, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Randerath, Winfried J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Andreas, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Waschki, Benjamin UNSPECIFIED orcid.org/0000-0002-1070-3661 UNSPECIFIED Kleibrink, Bjorn E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Welte, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Bals, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Schulz, Holger UNSPECIFIED UNSPECIFIED UNSPECIFIED Biertz, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Young, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Vogelmeier, Claus F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jorres, Rudolf A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-191591
DOI:	10.1016/j.rmed.2018.02.011
Journal or Publication Title:	Respir. Med.
Volume:	137
Page Range:	S. 14 - 23
Date:	2018
Publisher:	W B SAUNDERS CO LTD
Place of Publication:	LONDON
ISSN:	1532-3064
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DECOMPENSATED HEART-FAILURE; LATE GADOLINIUM ENHANCEMENT; PULMONARY-DISEASE; WALL STRESS; MYOCARDIAL-INFARCTION; INFLAMMATORY MARKERS; IMPACT; DYSFUNCTION; COMORBIDITIES; PREVALENCE Multiple languages Cardiac & Cardiovascular Systems; Respiratory System Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19159