Advances in understanding of mechanisms related to increased cardiovascular risk in COPD

Rogliani, Paola; Ritondo, Beatrice Ludovica; Laitano, Rossella; Chetta, Alfredo; Calzetta, Luigino

doi:10.1080/17476348.2021.1840982

Cited by 9 publications

(6 citation statements)

References 112 publications

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“…Thus, according to current evidence and the results of our study, we suggest that OS may impact on plaque development rather than early atherosclerosis onset. Besides traditional risk factors for ischemic stroke, such as aging, tobacco smoking, diabetes, or hypercholesterolemia and arterial hypertension, there is extensive evidence indicating that chronic low-grade systemic inflammation and oxidative stress, which are key pathophysiological drivers of both pathological wall remodeling in atherosclerosis ( 16 , 38 ) and COPD ( 39 – 41 ), can also induce cerebrovascular dysfunction and structural alterations of cerebral vessels increasing the risk for ischemic stroke in COPD patients ( 42 , 43 ). Regarding the impact of OS on cardiovascular morbidity and mortality in COPD patients, distinct large observational studies have yielded conflicting results ( 44 – 46 ).…”

Section: Discussionmentioning

confidence: 99%

Sleep apnea-COPD overlap syndrome is associated with larger left carotid atherosclerotic plaques

Landete

Fernández-García²,

Muñoz³

et al. 2023

Front. Cardiovasc. Med.

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BackgroundLittle is known about whether the overlap syndrome (OS) combining features of chronic obstructive pulmonary disease (COPD) and sleep apnea-hypopnea syndrome increases the risk of stroke associated with COPD itself.MethodsWe prospectively studied 74 COPD patients and 32 subjects without lung disease. Spirometry and cardiorespiratory polygraphy were used to assess the pulmonary function of the study population and ultrasound measurements of intima media thickness (IMT) as well as the volume of plaques in both carotid arteries were also evaluated.ResultsPolygraphic criteria of OS were met in 51% of COPD patients. We found that 79% of patients with OS and 50% of COPD patients without OS had atherosclerotic plaques in the left carotid artery (p = 0.0509). Interestingly, the mean volume of atherosclerotic plaques was significantly higher in the left carotid artery of COPD patients with OS (0.07 ± 0.02 ml) than in those without OS (0.04 ± 0.02 ml, p = 0.0305). However, regardless of the presence of OS, no significant differences were observed in both presence and volume of atherosclerotic plaques in the right carotid artery of COPD patients. Adjusted-multivariate linear regression revealed age, current smoking and the apnea/hypopnea index (OR = 4.54, p = 0.012) as independent predictors of left carotid atherosclerotic plaques in COPD patients.ConclusionsThis study suggests that the presence of OS in COPD patients is associated with larger left carotid atherosclerotic plaques, indicating that OS might be screened in all COPD patients to identify those with higher risk of stroke.

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Section: Discussionmentioning

confidence: 99%

Sleep apnea-COPD overlap syndrome is associated with larger left carotid atherosclerotic plaques

Landete

Fernández-García²,

Muñoz³

et al. 2023

Front. Cardiovasc. Med.

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“…As COPD correlated with a lot of cardiac disorders [ 56 – 58 ] and was suspected as a risk factor for cardiovascular comorbidity in patients with emphysema [ 59 , 60 ] and at last was recorded to have a high rate of arrhythmias [ 61 , 62 ], it was important to exclude the patients with COPD from the study.…”

Section: Discussionmentioning

confidence: 99%

ECG Abnormalities in Patients with Acute Exacerbation of Bronchiectasis and Factors Associated with High Probability of Abnormality

Alduihi

2021

Pulmonary Medicine

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Background. Bronchiectasis is an important reason for morbidity and mortality according to the last records that referred to high incidence rate of disease. Cardiovascular problems are common in pulmonary diseases, in general, and it can symptom by ECG abnormalities. The objective of this study was to define the most ECG abnormalities in patients with acute exacerbation of bronchiectasis and to study the correlation between the cardiac disorder and the other risk factors of the exacerbation. Materials and Methods. A prospective single-center observational cohort study was done at Aleppo University Hospital for patients with AEB between October 2017 and September 2018. They were divided into 2 groups (normal ECG vs. abnormal). Patients with COPD, cystic fibrosis, new diagnosis of ischemic accident through the last 6 months of the study, and treatment with macrolides or fluoroquinolones through the last 3 months of the study were excluded. We study the percent of abnormalities through the AEB and the percentage of the most common abnormalities. Results. 67 patients were included in the study (44 males and 23 females) with a mean age of 52.85 ± 21.456 . ECG abnormalities were recorded in 43 patients, and it was more common in men (67.44% of cases). Advanced age and survival state had a statistical significance ( p = 0.003 , 0.023), respectively, between the 2 groups. Right axis deviation (RAD) is the most common abnormality (23.3%) followed by sinus tachycardia (20.9%), and it is close to T-depression (18.6%). AF was the most common arrhythmia from all recorded arrhythmias (6.98% from all cases). Positive sputum cultures were recorded in 55.8%, and the most common isolated pathogen factor was Pseudomonas aeruginosa. Recurrent pneumonia was seen in 30.2% of all patients with abnormal ECG. We find a high prevalence of ECG abnormalities in patients with Oximetry (90-95%, 39.5%), and the opportunity for abnormalities is equal in the 2 age groups (45–59 and more than 75) that reflexed the possibility of cardiac disorders in any age in patients with AEB. Conclusions. ECG abnormalities are common in AEB, and it can happen in any age and any value of Oximetry. It needs more attention because of the prognosis of the cardiac morbidity.

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“…One may consider and rule out alternative diagnoses that may be a cause for their dyspnea such as asthma and cardiovascular disease. [9][10][11][12][13][14][15][16][17] Other considerations may include inducible laryngeal obstruction or dysfunctional breathing disorder, [18][19][20][21] but ultimately, they are unable to explain to their patients what the cause of their shortness of breath is, even though their presumption is that they likely have "early Pre-COPD." 1,2 Hence, there remains a keen interest in furthering our understanding of the underlying pathophysiological mechanisms for the not uncommon report of exertional dyspnea in smokers or former smokers with symptoms disproportionate to their lung function.…”

Section: Introductionmentioning

confidence: 99%

“…microvascular dysfunction. 12,14,17,[22][23][24][25][26] Other studies have examined the ventilatory efficiency--(minute ventilation [VE] to carbon dioxide production [VCO2]) VE/VCO2 nadir: the lowest ventilatory rate able to remove 1 liter of CO2 per minute during graded cardiopulmonary exercise testing (CPET). [27][28][29][30][31] While many clinicians are familiar with the concept of dynamic hyperinflation that can lead to breath stacking and dyspnea, fewer non-pulmonary physicians are familiar with the assessment of ventilatory efficiency.…”

Section: Introductionmentioning

confidence: 99%

Journal Club: Impaired Ventilatory Efficiency and Exercise Intolerance in Former/Current Smokers With Dyspnea Disproportionate to Their Lung Function: Pathophysiological Insights Gained Through Cardiopulmonary Exercise Testing

Balkissoon¹,

Mkorombindo²

2022

J COPD F

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Advances in understanding of mechanisms related to increased cardiovascular risk in COPD

Cited by 9 publications

References 112 publications

Sleep apnea-COPD overlap syndrome is associated with larger left carotid atherosclerotic plaques

Sleep apnea-COPD overlap syndrome is associated with larger left carotid atherosclerotic plaques

ECG Abnormalities in Patients with Acute Exacerbation of Bronchiectasis and Factors Associated with High Probability of Abnormality

Journal Club: Impaired Ventilatory Efficiency and Exercise Intolerance in Former/Current Smokers With Dyspnea Disproportionate to Their Lung Function: Pathophysiological Insights Gained Through Cardiopulmonary Exercise Testing

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