Background
Cardiovascular diseases (CVDs) are common in people with chronic obstructive pulmonary disease (COPD), and their presence is associated with an increased risk for hospitalization, longer length of stay and all-cause and CVD-related mortality. We assessed the role of angiotensin-converting enzyme (ACE) gene polymorphism in the occurrence of arterial hypertension (AH) in patients with COPD.
Methods
The study group consisted of 96 patients. Group 1 had 25 individuals with COPD, Group 2 had 23 individuals with AH and Group 3 had 28 individuals with COPD and AH. The control group consisted of 20 healthy subjects. I/D genotypes of ACE were determined by polymerase chain reaction amplification.
Results
The frequency distribution of polymorphic genotypes of the gene encoding ACE and assessment of compliance with the Hardy-Weinberg population equilibrium were carried out in groups of patients with COPD, AH and COPD + AH combination. The frequencies of the genotype responsible for I/D polymorphism of the ACE gene in the control and experimental groups were not found to deviate significantly from the Hardy–Weinberg equilibrium. The results of the study have not demonstrated any significant impact of alleles of ACE genes or ACE genes on occurrence of diseases such as COPD, AH and combinations thereof. However, analysis of odds ratio has demonstrated that the presence of the D allele of the ACE gene may increase the risk for occurrence of the COPD + AH (OR = 1.26).
Conclusion
The data obtained in the study allow suggesting that the presence of D allele of the ACE gene may increase the risk for AH in patients with COPD.
BackgroundCardiac arrhythmias represent one of the consequences of obstructive sleep apnea (OSA). The gold standard of moderate–severe symptomatic OSA treatment is positive pressure therapy [continuous positive airway pressure (CPAP)]. The use of CPAP in patients with cardiac arrhythmias and OSA may contribute to the maintenance of sinus rhythm.AimTo assess the effects of the CPAP therapy in addition to pharmacological and/or ablative interventions in maintaining the sinus rhythm in patients with cardiac arrhythmias and moderate–severe OSA.Materials and methodsPatients diagnosed with cardiac arrhythmias [atrial fibrillation (AF)/flutter] and high pretest OSA suspicion (at least two items out of the following: snoring, witnessed apneas, obesity and excessive daytime sleepiness), performed a cardiorespiratory polygraphy (nasal flowmetry, pulse oximetry, thoracoabdominal movements, snoring and body position) for positive diagnosis and OSA severity assessment. Patients with moderate–severe OSA underwent CPAP titration with consecutive therapy indication (CPAP therapy plus pharmacological and/or ablative intervention). At 1 year, patients who used CPAP (group A) and those without CPAP (group B) were re-evaluated for the presence or absence of cardiac arrhythmias.ResultsSixty-three patients with AF/flutter and high pretest suspicion of OSA performed cardiorespiratory polygraphy. Sixty patients (39 men) were diagnosed with OSA, out of which 40 (26 men) had moderate–severe OSA (apnea–hypopnea index, AHI ≥ 15/h) and underwent CPAP titration. At 1 year of follow-up, 17 patients (42.5%) were found adherent to the CPAP therapy (group A) and 23 (57.5%) did not use CPAP (group B). The two groups were similar in terms of age, body mass index, daytime sleepiness (assessed by Epworth Sleepiness Scale) and oxygen desaturation index, and statistically significant differences were recorded for the values of AHI and the time spent below SaO2 <90% (t90%), statistically significant higher (p < 0.01, respectively p < 0.04) in group A compared to group B. At 1 year, in group A, more patients had sinus rhythm compared to those with AF/flutter (13, respectively 4). In group B, 8 patients were in sinus rhythm and 15 with AF/flutter.ConclusionsThe CPAP therapy added to standard therapy (pharmacological therapy and/or ablative procedures) in patients with moderate–severe OSA and installed cardiovascular disease (arrhythmias) has a favourable effect on maintaining the sinus rhythm at 1 year of follow-up.
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