COPD maintenance medication is linked to left atrial size: Results from the COSYCONET cohort

Autor: Robert Bals, Johanna I. Lutter, Henrik Watz, Kathrin Kahnert, Peter Alter, Korbinian Berschneider, Rudolf A. Jörres, T. Speicher, Tobias Welte, Claus Vogelmeier, Christina Kellerer, Franziska C. Trudzinski
Rok vydání: 2021
Předmět:
Male
Cohort Studies
Pulmonary Disease
Chronic Obstructive
0302 clinical medicine
Maintenance therapy
Left atrial
Adrenal Cortex Hormones
030212 general & internal medicine
COPD
Ejection fraction
biology
LAMA
Lama
Adrenergic beta-Agonists
ddc
Bronchodilator Agents
Treatment Outcome
Echocardiography
Left atrium
Cohort
Cardiology
Regression Analysis
Drug Therapy
Combination
Female
Copd
Cardiac Size
Ics
Laba
Left Atrium
Maintenance Medication
hormones
hormone substitutes
and hormone antagonists
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Cardiac size
LABA
Muscarinic Antagonists
Maintenance Chemotherapy
03 medical and health sciences
Internal medicine
Administration
Inhalation
medicine
Humans
Heart Atria
Aged
business.industry
Patient Acuity
medicine.disease
biology.organism_classification
Maintenance medication
030228 respiratory system
ICS
Delayed-Action Preparations
Propensity score matching
Observational study
business
Follow-Up Studies
Zdroj: Respir. Med. 185:106461 (2021)
ISSN: 1532-3064
Popis: BACKGROUND: Lung function impairment in COPD is known to be related to reductions of left heart size, while short-term interventional trials with bronchodilators showed positive effects on cardiac parameters. We investigated whether COPD maintenance therapy has analogous long-term effects. METHODS: Pooled data of GOLD grade 1-4 patients from visits 1 and 3 (1.5y apart) of the COSYCONET cohort were used. Medication was categorized as use of ICS, LABA+ICS, LABA+LAMA and triple therapy (LABA+LAMA+ICS), contrasting "always" versus "never". Echocardiographic parameters comprised left ventricular end-diastolic and -systolic diameter (LVEDD, LVESD), ejection fraction (LVEF) and left atrial diameter (LA). Associations were identified by multiple regression analysis, as well as propensity score analysis. RESULTS: Overall, 846 patients (mean age 64.5y; 41% female) were included, 53% using ICS at both visits, 51% LABA+ICS, 56% LABA+LAMA, 40% LABA+LAMA+ICS (triple) therapy. Conversely, 30%, 32%, 28% and 42% had no ICS, LABA+ICS, LABA+LAMA or triple therapy, respectively, at both visits. Among echocardiographic measures, only LA showed statistically significant associations (increases) with medication, whereby significant effects were linked to ICS, LABA+ICS and LABA+LAMA (p 
Databáze: OpenAIRE
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