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      Electrocardiographic alterations in patients with chronic obstructive pulmonary disease

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          Abstract

          Patients with chronic obstructive pulmonary disease (COPD) have an increased risk for cardiovascular events, and electrocardiography has an important role in detecting cardiac side effects of COPD-related hypoxia.

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          Chronic obstructive pulmonary disease as a risk factor for cardiovascular morbidity and mortality.

          Don Sin, S. F. Paul Man (2005)
          Chronic obstructive pulmonary disease and other disorders, associated with reduced lung function, are strong risk factors for cardiovascular events, independent of smoking. Overall, when the lowest quintile of lung function, as measured by FEV1 is compared with the highest quintile, the risk of cardiovascular mortality increases by approximately 75% in both men and women. Having symptoms of chronic bronchitis alone increases the risk of coronary deaths by 50%. Reduced ratio of FEV1 to FVC by itself is a modest independent risk factor for coronary events, increasing the risk by 30%. However, if patients have ventricular arrhythmias, the risk of coronary events is increased twofold, suggesting that the cardiotoxic effects of obstructive airways disease are amplified in those who have underlying cardiac rhythm disturbances. In general, for every 10% decrease in FEV1, all-cause mortality increases by 14%, cardiovascular mortality increases by 28%, and nonfatal coronary event increases by almost 20%. These data indicate that chronic obstructive pulmonary disease is a powerful, independent risk factor for cardiovascular morbidity and mortality.
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            QRS-T angle as a predictor of sudden cardiac death in a middle-aged general population.

            Aapo Aro, Heikki Huikuri, Jani Tikkanen … (2012)
            Spatial QRS-T angle measured from a 12-lead electrocardiogram (ECG) has been shown to predict cardiac mortality. However, there is a paucity of studies on the prognostic significance of frontal QRS-T angle, which is more readily available from the standard 12-lead ECG. The purpose of the present study was to investigate the importance of wide frontal QRS-T angle, QRS-axis, and T-wave axis as cardiac risk predictors in general population.
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              High prevalence of altered cardiac repolarization in patients with COPD

              Noriane A. Sievi, Christian Clarenbach, Giovanni Camen … (2014)
              Background Altered cardiac repolarization and increased dispersion of repolarization have been identified as risk factors for sudden cardiac death (SCD). The prevalence of and the mechanisms contributing to altered cardiac repolarization are currently unknown in COPD. Methods In 91 COPD patients, 32 controls matched for age, cardiovascular risk and medication, and 41 healthy subjects, measures of cardiac repolarization and dispersion of repolarization (QTc interval, QT dispersion) were derived from 12-lead electrocardiography (ECG). Prevalence rates of heart rate corrected QT (QTc) >450ms and QT dispersion >60ms were determined to assess the number of subjects at risk for SCD. Univariate and multivariate analyses were used to identify possible factors contributing to altered cardiac repolarization. Results QTc was found to be prolonged in 31.9% and QT dispersion in 24.2% of the COPD patients compared to 12.5% in matched controls and 0% in healthy subjects. The QTc interval was longer in COPD patients compared to matched and healthy controls respectively (437.9 ± 29.5 vs. 420.1 ± 25.3 ms, p = 0.001 and vs. 413.4 ± 18.2 ms, p < 0.001). QT dispersion was significantly increased in COPD patients compared to healthy subjects (45.4 (34.8 , 59.5) vs. 39.7 (29.3 , 54.8) ms, p = 0.049). Only oxygen saturation was independently associated with QTc duration in multivariate analysis (β = -0.29, p = 0.015). Conclusion One third of a typical COPD population has altered cardiac repolarization and increased dispersion of repolarization, which may be related to hypoxia. Altered cardiac repolarization may expose these patients to an increased risk for malignant ventricular arrhythmias and SCD.
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                Author and article information

                Contributors
                Mehmet Eyuboglu
                Journal
                Journal ID (nlm-ta): World J Cardiol
                Journal ID (publisher-id): WJC
                Title: World Journal of Cardiology
                Publisher: Baishideng Publishing Group Inc
                ISSN (Electronic): 1949-8462
                Publication date (Print): 26 March 2022
                Publication date (Electronic): 26 March 2022
                Volume: 14
                Issue: 3
                Pages: 187-189
                Affiliations
                Department of Cardiology, Gaziosmanpasa University School of Medicine, Tokat 60030, Turkey. mhmtybgl@ 123456gmail.com
                Author notes

                Author contributions: Eyuboglu M solely contributed to this letter.

                Corresponding author: Mehmet Eyuboglu, MD, Doctor, Senior Researcher, Senior Scientist, Department of Cardiology, Gaziosmanpasa University School of Medicine, Kaleardi Mahallesi, Tokat 60030, Turkey. mhmtybgl@ 123456gmail.com

                Article
                Other ID: jWJC.v14.i3.pg187
                DOI: 10.4330/wjc.v14.i3.187
                PMC ID: 8968456
                SO-VID: c705421d-3e41-4149-9507-b4d4b0ec1385
                Copyright © ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
                License:

                This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

                History
                Date received : 28 October 2021
                Date revision received : 27 December 2021
                Date accepted : 20 February 2022
                Categories
                Subject: Letter to the Editor

                Keywords: electrocardiography,chronic obstructive pulmonary disease,qt interval,qt dispersion,frontal plane qrs-t angle,fragmented qrs
                Data availability:
                Keywords: electrocardiography, chronic obstructive pulmonary disease, qt interval, qt dispersion, frontal plane qrs-t angle, fragmented qrs

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