Premature Ventricular Complex is More Prevalent During Acute Exacerbated than Stable States of Chronic Obstructive Pulmonary Disease, and Is Related to Cardiac Troponin T
| Autor: | Vidar Søyseth, Nils Henrik Holmedahl, Gunnar Einvik, Anke Neukamm, Torbjørn Omland, Rahul Bhatnagar |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Acute exacerbation of chronic obstructive pulmonary disease Cardiac troponin Pulmonary disease 030204 cardiovascular system & hematology Pulmonary Disease Chronic Obstructive 03 medical and health sciences 0302 clinical medicine Troponin T Heart Rate Internal medicine Tachycardia Supraventricular medicine Humans Intensive care medicine Aged Stable state Premature ventricular complexes COPD medicine.diagnostic_test business.industry Middle Aged medicine.disease Ventricular Premature Complexes C-Reactive Protein Cross-Sectional Studies 030228 respiratory system Acute Disease Disease Progression Electrocardiography Ambulatory Cardiology cardiovascular system Female business Electrocardiography |
| ISSN: | 1541-2555 |
| Popis: | During acute exacerbation of chronic obstructive pulmonary disease (AECOPD), myocardial stress may be aggravated. Sparse data exist concerning the prevalence and correlates of cardiac arrhythmias in the stable and exacerbated states of COPD. We hypothesized that AECOPD is associated with increased prevalence of cardiac arrhythmias independent of COPD-severity and co-morbidity, and explored possible mechanisms. A 24-hour Holter recording was obtained in 74 patients with stable COPD and 45 patients with AECOPD (mean age 54 years, 56% women). Any incidence of supraventricular tachycardia (SVT), frequent premature ventricular complex (PVC, >30/hour) and complex ventricular ectopy (bigeminy, trigeminy or non-sustained ventricular tachycardia) was recorded and compared between the two groups. Adjustments were made for by stable disease-related co-variates (demography, co-morbidity, COPD-severity) and by acute disease-related co-variates (heart rate, cardiac troponin T (cTnT), PO2, PCO2 and C-reactive protein (CRP)) in explorative analyses. The prevalence of SVT, frequent PVCs or complex ventricular ectopy was 40%, 27% and 33% in AECOPD, and 31%, 31% and 12% in stable COPD, respectively. Frequent PVC, but not SVT or complex ventricular ectopy, was significantly increased in AECOPD compared to stable COPD, odds ratio 3.03 (1.03–10.5, p = 0.039) when adjusted for stable disease-related co-variates. Higher heart rate, cTnT and CRP attenuated the association between AECOPD and frequent PVC to non-significant, while heart rate remained associated with frequent PVC. In conclusion, frequent PVC is more prevalent in exacerbated than in the stable states of COPD. Attenuation effects of cTnT, tachycardia and CRP suggest that cardiac stress or inflammation may be involved in mechanisms causing frequent PVC i AECOPD. © 2017 Taylor & Francis |
| Databáze: | OpenAIRE |
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